52D2258065 CLIA NUMBER - WALMART PHARMACY 10-3268

Laboratory Demographics

CLIA Number: 52D2258065

Facility Name: WALMART PHARMACY 10-3268

Facility Address:
200 E STATE HIGHWAY 64
ANTIGO, WI
ZIP 54409
Get Directions

Facility Phone Number: 262 740-2549

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790702868

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	52D2258065
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-3268
Street	200 E STATE HIGHWAY 64
City	ANTIGO
State	WI
ZIP	54409
Phone	262 740-2549
CertificateType	4
CertificateEffectiveDate	4/15/2024
CertificateExpirationDate	4/14/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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