36D2175528 CLIA NUMBER - WALMART PHARMACY 10-2063

Laboratory Demographics

CLIA Number: 36D2175528

Facility Name: WALMART PHARMACY 10-2063

Facility Address:
6001 MAHONING AVE
AUSTINTOWN, OH
ZIP 44515
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Facility Phone Number: 330 270-0006

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1902823198

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	36D2175528
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-2063
Street	6001 MAHONING AVE
City	AUSTINTOWN
State	OH
ZIP	44515
Phone	330 270-0006
CertificateType	4
CertificateEffectiveDate	11/22/2023
CertificateExpirationDate	11/21/2025
FacilityType	Waiver

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