45D2134998 CLIA NUMBER - WALMART PHARMACY 10-0791

Laboratory Demographics

CLIA Number: 45D2134998

Facility Name: WALMART PHARMACY 10-0791

Facility Address:
2701 E MAIN STREET
ALICE, TX
ZIP 78332
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Facility Phone Number: 361 668-0504

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1619994886

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	45D2134998
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0791
Street	2701 E MAIN STREET
City	ALICE
State	TX
ZIP	78332
Phone	361 668-0504
CertificateType	4
CertificateEffectiveDate	8/14/2023
CertificateExpirationDate	8/13/2025
FacilityType	Waiver

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