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45D2101452 CLIA NUMBER - WALMART CARE CLINIC 10-5247

Laboratory Demographics

CLIA Number: 45D2101452

Facility Name: WALMART CARE CLINIC 10-5247

Facility Address:
1228 NORTH HIGHWAY 377
ROANOKE, TX
ZIP 76262
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Facility Phone Number: 682 831-1957

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1659398717

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 45D2101452
LAB Type Pharmacy
Facility Name WALMART CARE CLINIC 10-5247
Street 1228 NORTH HIGHWAY 377
City ROANOKE
State TX
ZIP 76262
Phone 682 831-1957
CertificateType 4
CertificateEffectiveDate 12/3/2022
CertificateExpirationDate 12/2/2024
FacilityType Waiver

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