10D2180121 CLIA NUMBER - WAL-MART STORE EAST LP

Laboratory Demographics

  • CLIA Code: 10D2180121
  • Facility Name: WAL-MART STORE EAST LP
  • Facility Address: 6885 S SUNCOAST BLVD
    HOMOSASSA, FL
    ZIP 34446
  • Facility Phone: 352 628-4334
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EYDA F. THOMAS
  • NPI Number: 1699792069
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2180121
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST LP
Street 6885 S SUNCOAST BLVD
City HOMOSASSA
State FL
ZIP 34446
Phone 352 628-4334
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 EYDA F. THOMAS

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