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34D2142108 CLIA NUMBER - WALMART PHARMACY 10-5292

Laboratory Demographics

CLIA Number: 34D2142108

Facility Name: WALMART PHARMACY 10-5292

Facility Address:
4431 NEW BERN AVENUE
RALEIGH, NC
ZIP 27610
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Facility Phone Number: 919 212-6169

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1952328122

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 34D2142108
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5292
Street 4431 NEW BERN AVENUE
City RALEIGH
State NC
ZIP 27610
Phone 919 212-6169
CertificateType 4
CertificateEffectiveDate 1/3/2024
CertificateExpirationDate 1/2/2026
FacilityType Waiver

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