52D2258903 CLIA NUMBER - WALMART PHARMACY 10-1365

Laboratory Demographics

CLIA Number: 52D2258903

Facility Name: WALMART PHARMACY 10-1365

Facility Address:
2222 CREST VIEW DR
HUDSON, WI
ZIP 54016
Get Directions

Facility Phone Number: 715 386-1345

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1467479519

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	52D2258903
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-1365
Street	2222 CREST VIEW DR
City	HUDSON
State	WI
ZIP	54016
Phone	715 386-1345
CertificateType	4
CertificateEffectiveDate	4/28/2024
CertificateExpirationDate	4/27/2026
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