36D2121906 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART #10-2441

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Laboratory Demographics

CLIA Number: 36D2121906

Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART #10-2441

Facility Address:
1505 MAIN STREET
HAMILTON, OH
ZIP 45013
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Facility Phone Number: 479 258-7034

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1295752483

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	36D2121906
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST, LP DBA WAL-MART #10-2441
Street	1505 MAIN STREET
City	HAMILTON
State	OH
ZIP	45013
Phone	479 258-7034
CertificateType	4
CertificateEffectiveDate	11/16/2022
CertificateExpirationDate	11/15/2024
FacilityType	Waiver

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