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36D2122516 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-2323

Laboratory Demographics

CLIA Number: 36D2122516

Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-2323

Facility Address:
3520 HUDSON DRIVE
STOW, OH
ZIP 44224
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Facility Phone Number: 479 258-7034

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1386661585

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 36D2122516
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-2323
Street 3520 HUDSON DRIVE
City STOW
State OH
ZIP 44224
Phone 479 258-7034
CertificateType 4
CertificateEffectiveDate 11/30/2022
CertificateExpirationDate 11/29/2024
FacilityType Waiver

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