45D2119303 CLIA NUMBER - WALMART PHARMACY 10-3057

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Laboratory Demographics

CLIA Number: 45D2119303

Facility Name: WALMART PHARMACY 10-3057

Facility Address:
12550 LESLIE ROAD
HELOTES, TX
ZIP 78023
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Facility Phone Number: 210 507-4982

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1780923904

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	45D2119303
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-3057
Street	12550 LESLIE ROAD
City	HELOTES
State	TX
ZIP	78023
Phone	210 507-4982
CertificateType	4
CertificateEffectiveDate	9/23/2022
CertificateExpirationDate	9/22/2024
FacilityType	Waiver

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