45D2117121 CLIA NUMBER - WALMART PHARMACY 10-963

Laboratory Demographics

CLIA Number: 45D2117121

Facility Name: WALMART PHARMACY 10-963

Facility Address:
1836 S MAIN STREET
WEATHERFORD, TX
ZIP 76086
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Facility Phone Number: 817 599-4166

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134146384

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	45D2117121
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-963
Street	1836 S MAIN STREET
City	WEATHERFORD
State	TX
ZIP	76086
Phone	817 599-4166
CertificateType	4
CertificateEffectiveDate	8/9/2022
CertificateExpirationDate	8/8/2024
FacilityType	Waiver

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