10D2180108 CLIA NUMBER - WAL-MART STORE EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2180108
  • Facility Name: WAL-MART STORE EAST, LP
  • Facility Address: 1040 MALABAR RD SE
    PALM BAY, FL
    ZIP 32907
  • Facility Phone: (321) 723-2101
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACOB WALLS
  • NPI Number: 1326065632
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2180108
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST, LP
Street 1040 MALABAR RD SE
City PALM BAY
State FL
ZIP 32907
Phone 3217232101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2026
Certificate Expiration Date 3/5/2028
Facility Type Pharmacy
Lab Director JACOB WALLS

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This page was last updated on: 5/18/2026