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37D2129717 CLIA NUMBER - WALMART PHARMACY 10-0038

Laboratory Demographics

CLIA Number: 37D2129717

Facility Name: WALMART PHARMACY 10-0038

Facility Address:
1907 SE WASHINGTON ST
IDABEL, OK
ZIP 74745
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Facility Phone Number: 580 286-3323

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1699792721

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 37D2129717
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0038
Street 1907 SE WASHINGTON ST
City IDABEL
State OK
ZIP 74745
Phone 580 286-3323
CertificateType 4
CertificateEffectiveDate 4/25/2023
CertificateExpirationDate 4/24/2025
FacilityType Waiver

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