34D2139107 CLIA NUMBER - WALMART PHARMACY 10-1096

Laboratory Demographics

CLIA Number: 34D2139107

Facility Name: WALMART PHARMACY 10-1096

Facility Address:
261 COOPER CREEK DR
MOCKSVILLE, NC
ZIP 27028
Get Directions

Facility Phone Number: 336 751-1340

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1427075662

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	34D2139107
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-1096
Street	261 COOPER CREEK DR
City	MOCKSVILLE
State	NC
ZIP	27028
Phone	336 751-1340
CertificateType	4
CertificateEffectiveDate	10/31/2023
CertificateExpirationDate	10/30/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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