10D2178446 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2178446
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 1101 BEVILLE RD ATTENTION WALMART PHARMACY 10-1391
    DAYTONA BEACH, FL
    ZIP 32119
  • Facility Phone: 386 760-4447
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALAN THOMASON
  • NPI Number: 1407873888
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2178446
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 1101 BEVILLE RD ATTENTION WALMART PHARMACY 10-1391
City DAYTONA BEACH
State FL
ZIP 32119
Phone 386 760-4447
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2024
Certificate Expiration Date 2/3/2026
Facility Type Pharmacy
Lab Director ALAN THOMASON

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This page was last updated on: 9/29/2025