10D2180120 CLIA NUMBER - WAL-MART STORE EAST LP

Laboratory Demographics

  • CLIA Code: 10D2180120
  • Facility Name: WAL-MART STORE EAST LP
  • Facility Address: 6192 GUNN HWY
    TAMPA, FL
    ZIP 33625
  • Facility Phone: 813 963-4359
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTINA PHAN
  • NPI Number: 1154348456
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2180120
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST LP
Street 6192 GUNN HWY
City TAMPA
State FL
ZIP 33625
Phone 813 963-4359
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2024
Certificate Expiration Date 3/5/2026
Facility Type Pharmacy
Lab Director CHRISTINA PHAN

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