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45D2124494 CLIA NUMBER - WALMART PHARMACY 10-6300

Laboratory Demographics

CLIA Number: 45D2124494

Facility Name: WALMART PHARMACY 10-6300

Facility Address:
500 RICHLAND BOULEVARD
PROSPER, TX
ZIP 75078
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Facility Phone Number: 972 347-9572

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1285168039

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 45D2124494
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6300
Street 500 RICHLAND BOULEVARD
City PROSPER
State TX
ZIP 75078
Phone 972 347-9572
CertificateType 4
CertificateEffectiveDate 1/18/2023
CertificateExpirationDate 1/17/2025
FacilityType Waiver

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