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50D2175093 CLIA NUMBER - WALMART PHARMACY #10-3053

Laboratory Demographics

CLIA Number: 50D2175093

Facility Name: WALMART PHARMACY #10-3053

Facility Address:
1605 SE EVERETT MALL WAY
EVERETT, WA
ZIP 98208
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Facility Phone Number: 425 789-3364

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1598166001

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name Field Value
CLIA Number 50D2175093
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3053
Street 1605 SE EVERETT MALL WAY
City EVERETT
State WA
ZIP 98208
Phone 425 789-3364
CertificateType 4
CertificateEffectiveDate 11/14/2019
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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