10D2178972 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2178972
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 4255 ALAFAYA TRL ATTN WALMART PHARMACY 10-5106
    OVIEDO, FL
    ZIP 32765
  • Facility Phone: 407 359-6989
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANE A. FOX
  • NPI Number: 1104843507
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2178972
LAB Type Physician Office
Facility Name WAL-MART STORES EAST LP
Street 4255 ALAFAYA TRL ATTN WALMART PHARMACY 10-5106
City OVIEDO
State FL
ZIP 32765
Phone 407 359-6989
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2024
Certificate Expiration Date 2/11/2026
Facility Type Physician Office
Lab Director SHANE A. FOX

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