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50D2175103 CLIA NUMBER - WALMART PHARMACY #10-3531

Laboratory Demographics

CLIA Number: 50D2175103

Facility Name: WALMART PHARMACY #10-3531

Facility Address:
1401 GALAXY DR NE
LACEY, WA
ZIP 98516
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Facility Phone Number: 360 456-7862

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1821015959

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 50D2175103
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3531
Street 1401 GALAXY DR NE
City LACEY
State WA
ZIP 98516
Phone 360 456-7862
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