49D2129851 CLIA NUMBER - WALMART PHARMACY 10-4514

Laboratory Demographics

CLIA Number: 49D2129851

Facility Name: WALMART PHARMACY 10-4514

Facility Address:
201 MARANTO MANOR DRIVE
WINCHESTER, VA
ZIP 22602
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Facility Phone Number: 540 868-5109

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1811277072

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	49D2129851
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-4514
Street	201 MARANTO MANOR DRIVE
City	WINCHESTER
State	VA
ZIP	22602
Phone	540 868-5109
CertificateType	4
CertificateEffectiveDate	4/26/2023
CertificateExpirationDate	4/25/2025
FacilityType	Waiver

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