10D2178739 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2178739
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 904 CYPRESS PKWY ATTN WALMART PHARMACY 10-5250
    KISSIMMEE, FL
    ZIP 34759
  • Facility Phone: 407 870-2501
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHEN ROJAS
  • NPI Number: 1225055528
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2178739
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 904 CYPRESS PKWY ATTN WALMART PHARMACY 10-5250
City KISSIMMEE
State FL
ZIP 34759
Phone 407 870-2501
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 STEPHEN ROJAS

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