10D2188904 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2188904
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 9300 NW 77TH AVE
    HIALEAH GARDENS, FL
    ZIP 33016
  • Facility Phone: 305 819-0858
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAYLIN BLANCO
  • NPI Number: 1306863709
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2188904
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 9300 NW 77TH AVE
City HIALEAH GARDENS
State FL
ZIP 33016
Phone 305 819-0858
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 MAYLIN BLANCO

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