10D2178982 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2178982
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 5991 S GOLDENROD RD ATN WALMART PHARMACY 10-3782
    ORLANDO, FL
    ZIP 32822
  • Facility Phone: 407 382-8383
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY LUCK
  • NPI Number: 1114196177
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 10D2178982
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 5991 S GOLDENROD RD ATN WALMART PHARMACY 10-3782
City ORLANDO
State FL
ZIP 32822
Phone 407 382-8383
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 Pharmacy
Lab Director ASHLEY LUCK

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