45D2135925 CLIA NUMBER - WALMART PHARMACY 10-251

Laboratory Demographics

CLIA Number: 45D2135925

Facility Name: WALMART PHARMACY 10-251

Facility Address:
135 NE LOOP 564
MINEOLA, TX
ZIP 75773
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Facility Phone Number: 903 569-5485

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1194742320

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	45D2135925
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-251
Street	135 NE LOOP 564
City	MINEOLA
State	TX
ZIP	75773
Phone	903 569-5485
CertificateType	4
CertificateEffectiveDate	8/30/2023
CertificateExpirationDate	8/29/2025
FacilityType	Waiver

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