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49D2146388 CLIA NUMBER - WALMART PHARMACY 10-3588

Laboratory Demographics

CLIA Number: 49D2146388

Facility Name: WALMART PHARMACY 10-3588

Facility Address:
17041 JEFFERSON DAVIS HWY
DUMFRIES, VA
ZIP 22026
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Facility Phone Number: 703 221-7892

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1104843226

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 49D2146388
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3588
Street 17041 JEFFERSON DAVIS HWY
City DUMFRIES
State VA
ZIP 22026
Phone 703 221-7892
CertificateType 4
CertificateEffectiveDate 3/28/2024
CertificateExpirationDate 3/27/2026
FacilityType Waiver

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