10D2178679 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2178679
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 2125 NOLTE RD ATTN WALMART PHARMACY 10-5265
    SAINT CLOUD, FL
    ZIP 34772
  • Facility Phone: 407 556-0994
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELIZABETH ODU
  • NPI Number: 1477912772
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2178679
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 2125 NOLTE RD ATTN WALMART PHARMACY 10-5265
City SAINT CLOUD
State FL
ZIP 34772
Phone 407 556-0994
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Pharmacy
Lab Director ELIZABETH ODU

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