10D2188884 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2188884
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 19501 NW 27TH AVE
    MIAMI GARDENS, FL
    ZIP 33056
  • Facility Phone: 305 622-6668
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EDUARDO JIMENEZ
  • NPI Number: 1205944691
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2188884
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 19501 NW 27TH AVE
City MIAMI GARDENS
State FL
ZIP 33056
Phone 305 622-6668
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Pharmacy
Lab Director EDUARDO JIMENEZ

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