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45D2122886 CLIA NUMBER - WALMART PHARMACY 10-286

Laboratory Demographics

CLIA Number: 45D2122886

Facility Name: WALMART PHARMACY 10-286

Facility Address:
700 E ENNIS AVE
ENNIS, TX
ZIP 75119
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Facility Phone Number: 972 875-9636

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1255358420

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 45D2122886
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-286
Street 700 E ENNIS AVE
City ENNIS
State TX
ZIP 75119
Phone 972 875-9636
CertificateType 4
CertificateEffectiveDate 12/8/2022
CertificateExpirationDate 12/7/2024
FacilityType Waiver

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