49D2122148 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-3603

Laboratory Demographics

CLIA Number: 49D2122148

Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-3603

Facility Address:
16807 FOREST ROAD
FOREST, VA
ZIP 24551
Get Directions

Facility Phone Number: 479 258-6734

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1669865986

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	49D2122148
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-3603
Street	16807 FOREST ROAD
City	FOREST
State	VA
ZIP	24551
Phone	479 258-6734
CertificateType	4
CertificateEffectiveDate	11/21/2022
CertificateExpirationDate	11/20/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

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

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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