45D2136557 CLIA NUMBER - WALMART PHARMACY 10-3645

Laboratory Demographics

CLIA Number: 45D2136557

Facility Name: WALMART PHARMACY 10-3645

Facility Address:
200 W INTERSTATE 20
MIDLAND, TX
ZIP 79701
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Facility Phone Number: 432 684-4425

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1902823073

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	45D2136557
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-3645
Street	200 W INTERSTATE 20
City	MIDLAND
State	TX
ZIP	79701
Phone	432 684-4425
CertificateType	4
CertificateEffectiveDate	9/12/2023
CertificateExpirationDate	9/11/2025
FacilityType	Waiver

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