34D2119611 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-1322

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Laboratory Demographics

CLIA Number: 34D2119611

Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-1322

Facility Address:
160 LOWES BOULEVARD
LEXINGTON, NC
ZIP 27292
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Facility Phone Number: 479 258-6734

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558388702

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	34D2119611
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-1322
Street	160 LOWES BOULEVARD
City	LEXINGTON
State	NC
ZIP	27292
Phone	479 258-6734
CertificateType	4
CertificateEffectiveDate	9/30/2022
CertificateExpirationDate	9/29/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024