45D2119525 CLIA NUMBER - WALMART PHARMACY 10-2086

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Laboratory Demographics

CLIA Number: 45D2119525

Facility Name: WALMART PHARMACY 10-2086

Facility Address:
1700 DALLAS PARKWAY
PLANO, TX
ZIP 75093
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Facility Phone Number: 972 931-5176

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1811914088

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	45D2119525
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-2086
Street	1700 DALLAS PARKWAY
City	PLANO
State	TX
ZIP	75093
Phone	972 931-5176
CertificateType	4
CertificateEffectiveDate	9/28/2022
CertificateExpirationDate	9/27/2024
FacilityType	Waiver

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