42D2174242 CLIA NUMBER - WALMART PHARMACY 10-644

Laboratory Demographics

CLIA Number: 42D2174242

Facility Name: WALMART PHARMACY 10-644

Facility Address:
651 HIGHWAY 28 BYP
ANDERSON, SC
ZIP 29624
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Facility Phone Number: 864 261-7459

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831116094

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	42D2174242
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-644
Street	651 HIGHWAY 28 BYP
City	ANDERSON
State	SC
ZIP	29624
Phone	864 261-7459
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