10D2180011 CLIA NUMBER - WAL-MART STORE EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2180011
  • Facility Name: WAL-MART STORE EAST, LP
  • Facility Address: 22100 S STATE ROAD 7
    BOCA RATON, FL
    ZIP 33428
  • Facility Phone: 561 226-3158
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL NEKTALOW
  • NPI Number: 1346652054
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2180011
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST, LP
Street 22100 S STATE ROAD 7
City BOCA RATON
State FL
ZIP 33428
Phone 561 226-3158
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2024
Certificate Expiration Date 3/4/2026
Facility Type Pharmacy
Lab Director MICHAEL NEKTALOW

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