Healther Providers Data Logo

45D2125489 CLIA NUMBER - WALMART PHARMACY 10-2105

Laboratory Demographics

CLIA Number: 45D2125489

Facility Name: WALMART PHARMACY 10-2105

Facility Address:
4122 LBJ FREEWAY
DALLAS, TX
ZIP 75244
Get Directions

Facility Phone Number: 972 239-4297

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1093732265

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 45D2125489
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2105
Street 4122 LBJ FREEWAY
City DALLAS
State TX
ZIP 75244
Phone 972 239-4297
CertificateType 4
CertificateEffectiveDate 2/8/2023
CertificateExpirationDate 2/7/2025
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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