10D2179259 CLIA NUMBER - WAL-MART STORE EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2179259
  • Facility Name: WAL-MART STORE EAST, LP
  • Facility Address: 2101 S HWY 77
    LYNN HAVEN, FL
    ZIP 32444
  • Facility Phone: 850 265-2696
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEYURKUMAR PATEL
  • NPI Number: 1881611259
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2179259
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST, LP
Street 2101 S HWY 77
City LYNN HAVEN
State FL
ZIP 32444
Phone 850 265-2696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2024
Certificate Expiration Date 2/18/2026
Facility Type Pharmacy
Lab Director KEYURKUMAR PATEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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