10D2179661 CLIA NUMBER - WAL-MART STORE EAST LP

Laboratory Demographics

  • CLIA Code: 10D2179661
  • Facility Name: WAL-MART STORE EAST LP
  • Facility Address: 5700 NW 23RD ST
    GAINESVILLE, FL
    ZIP 32653
  • Facility Phone: 352 378-0759
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FREDA DUBERY
  • NPI Number: 1780601096
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2179661
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST LP
Street 5700 NW 23RD ST
City GAINESVILLE
State FL
ZIP 32653
Phone 352 378-0759
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Pharmacy
Lab Director FREDA DUBERY

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