42D2174234 CLIA NUMBER - WALMART PHARMACY 10-1244

Laboratory Demographics

CLIA Number: 42D2174234

Facility Name: WALMART PHARMACY 10-1244

Facility Address:
3027 WADE HAMPTON BLVD
TAYLORS, SC
ZIP 29687
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Facility Phone Number: 864 292-2014

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1255358404

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	42D2174234
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-1244
Street	3027 WADE HAMPTON BLVD
City	TAYLORS
State	SC
ZIP	29687
Phone	864 292-2014
CertificateType	4
CertificateEffectiveDate	10/29/2023
CertificateExpirationDate	10/28/2025
FacilityType	Waiver

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