10D2188574 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2188574
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 17105 SAN CARLOS BLVD
    FORT MYERS BEACH, FL
    ZIP 33931
  • Facility Phone: 239 340-7073
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GINO SINIGAGLIO
  • NPI Number: 1700256286
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 10D2188574
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 17105 SAN CARLOS BLVD
City FORT MYERS BEACH
State FL
ZIP 33931
Phone 239 340-7073
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Pharmacy
Lab Director GINO SINIGAGLIO

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