37D2120492 CLIA NUMBER - WALMART PHARMACY 10-5323

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Laboratory Demographics

CLIA Number: 37D2120492

Facility Name: WALMART PHARMACY 10-5323

Facility Address:
13503 S SANTA FE AVE
OKLAHOMA CITY, OK
ZIP 73170
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Facility Phone Number: 479 258-2243

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1316318934

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	37D2120492
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-5323
Street	13503 S SANTA FE AVE
City	OKLAHOMA CITY
State	OK
ZIP	73170
Phone	479 258-2243
CertificateType	4
CertificateEffectiveDate	10/18/2022
CertificateExpirationDate	10/17/2024
FacilityType	Waiver

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