10D2180347 CLIA NUMBER - WAL-MART STORE EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2180347
  • Facility Name: WAL-MART STORE EAST, LP
  • Facility Address: 5001 TAYLOR RD
    PUNTA GORDA, FL
    ZIP 33950
  • Facility Phone: 941 637-8838
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REBECCA BOLT
  • NPI Number: 1326065533
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2180347
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST, LP
Street 5001 TAYLOR RD
City PUNTA GORDA
State FL
ZIP 33950
Phone 941 637-8838
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type Pharmacy
Lab Director REBECCA BOLT

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