45D2117480 CLIA NUMBER - WALMART (SAMS CLUB) PHARMACY 10 5191

Laboratory Demographics

CLIA Number: 45D2117480

Facility Name: WALMART (SAMS CLUB) PHARMACY 10 5191

Facility Address:
802 E US HIGHWAY 80
FORNEY, TX
ZIP 75126
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Facility Phone Number: 972 564-9160

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558388611

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	45D2117480
LAB Type	Pharmacy
Facility Name	WALMART (SAMS CLUB) PHARMACY 10 5191
Street	802 E US HIGHWAY 80
City	FORNEY
State	TX
ZIP	75126
Phone	972 564-9160
CertificateType	4
CertificateEffectiveDate	8/17/2022
CertificateExpirationDate	8/16/2024
FacilityType	Waiver

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