51D2127609 CLIA NUMBER - WALMART PHARMACY 10-2933

Laboratory Demographics

CLIA Number: 51D2127609

Facility Name: WALMART PHARMACY 10-2933

Facility Address:
201 GREASY RIDGE RD
PRINCETON, WV
ZIP 24739
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Facility Phone Number: 304 431-2105

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1093732133

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	51D2127609
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-2933
Street	201 GREASY RIDGE RD
City	PRINCETON
State	WV
ZIP	24739
Phone	304 431-2105
CertificateType	4
CertificateEffectiveDate	3/15/2023
CertificateExpirationDate	3/14/2025
FacilityType	Waiver

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