36D2157810 CLIA NUMBER - WALMART PHARMACY #10-1913

Laboratory Demographics

CLIA Number: 36D2157810

Facility Name: WALMART PHARMACY #10-1913

Facility Address:
131 W GYPSY LANE RD
BOWLING GREEN, OH
ZIP 43402
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Facility Phone Number: 419 352-3776

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1801814652

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	36D2157810
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY #10-1913
Street	131 W GYPSY LANE RD
City	BOWLING GREEN
State	OH
ZIP	43402
Phone	419 352-3776
CertificateType	4
CertificateEffectiveDate	11/14/2022
CertificateExpirationDate	11/13/2024
FacilityType	Waiver

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