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50D2174949 CLIA NUMBER - WALMART PHARMACY #10-4757

Laboratory Demographics

CLIA Number: 50D2174949

Facility Name: WALMART PHARMACY #10-4757

Facility Address:
5110 YELM HIWY SE
LACEY, WA
ZIP 98503
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Facility Phone Number: 360 252-2907

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1275941361

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 50D2174949
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-4757
Street 5110 YELM HIWY SE
City LACEY
State WA
ZIP 98503
Phone 360 252-2907
CertificateType 4
CertificateEffectiveDate 11/12/2019
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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