10D2180146 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2180146
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 3791 NW 167TH STREET
    MIAMI GARDENS, FL
    ZIP 33055
  • Facility Phone: 305 914-1974
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHEILA GOODMAN
  • NPI Number: 1053710566
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2180146
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 3791 NW 167TH STREET
City MIAMI GARDENS
State FL
ZIP 33055
Phone 305 914-1974
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2024
Certificate Expiration Date 3/8/2026
Facility Type Pharmacy
Lab Director SHEILA GOODMAN

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