10D2189384 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2189384
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 508 10TH ST E
    PALMETTO, FL
    ZIP 34221
  • Facility Phone: 941 723-2677
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAI NGO
  • NPI Number: 1962429274
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2189384
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 508 10TH ST E
City PALMETTO
State FL
ZIP 34221
Phone 941 723-2677
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Pharmacy
Lab Director TAI NGO

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