10D2180170 CLIA NUMBER - WAL-MART STORE EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2180170
  • Facility Name: WAL-MART STORE EAST, LP
  • Facility Address: 17030 US HIGHWAY 441
    MOUNT DORA, FL
    ZIP 32757
  • Facility Phone: 352 735-0011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NA PHAM
  • NPI Number: 1952328262
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2180170
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST, LP
Street 17030 US HIGHWAY 441
City MOUNT DORA
State FL
ZIP 32757
Phone 352 735-0011
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 NA PHAM

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