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37D2154296 CLIA NUMBER - WALMART PHARMACY 10-5286

Laboratory Demographics

CLIA Number: 37D2154296

Facility Name: WALMART PHARMACY 10-5286

Facility Address:
9320 N PENNSYLVANIA PL
VILLAGE, OK
ZIP 73120
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Facility Phone Number: 405 840-2105

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1689692378

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 37D2154296
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5286
Street 9320 N PENNSYLVANIA PL
City VILLAGE
State OK
ZIP 73120
Phone 405 840-2105
CertificateType 4
CertificateEffectiveDate 9/11/2022
CertificateExpirationDate 9/10/2024
FacilityType Waiver

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