36D2159258 CLIA NUMBER - WALMART PHARMACY #10-2429

Laboratory Demographics

CLIA Number: 36D2159258

Facility Name: WALMART PHARMACY #10-2429

Facility Address:
2100 N BECHTLE AVE
SPRINGFIELD, OH
ZIP 45504
Get Directions

Facility Phone Number: 937 399-2045

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1538187380

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	36D2159258
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY #10-2429
Street	2100 N BECHTLE AVE
City	SPRINGFIELD
State	OH
ZIP	45504
Phone	937 399-2045
CertificateType	4
CertificateEffectiveDate	12/14/2022
CertificateExpirationDate	12/13/2024
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