45D2138570 CLIA NUMBER - WALMART PHARMACY 10-1126

Laboratory Demographics

CLIA Number: 45D2138570

Facility Name: WALMART PHARMACY 10-1126

Facility Address:
1381 S MAIN STREET
BOERNE, TX
ZIP 78006
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Facility Phone Number: 830 816-3587

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1114944360

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	45D2138570
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-1126
Street	1381 S MAIN STREET
City	BOERNE
State	TX
ZIP	78006
Phone	830 816-3587
CertificateType	4
CertificateEffectiveDate	10/20/2023
CertificateExpirationDate	10/19/2025
FacilityType	Waiver

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