10D2182107 CLIA NUMBER - WAL-MART STORE EAST LP

Laboratory Demographics

  • CLIA Code: 10D2182107
  • Facility Name: WAL-MART STORE EAST LP
  • Facility Address: 1385 AMELIA PLZ
    FERNANDINA BEACH, FL
    ZIP 32034
  • Facility Phone: 904 261-5522
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAM BLEDSOE
  • NPI Number: 1851318067
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2182107
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST LP
Street 1385 AMELIA PLZ
City FERNANDINA BEACH
State FL
ZIP 32034
Phone 904 261-5522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type Pharmacy
Lab Director WILLIAM BLEDSOE

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