10D2189492 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2189492
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 748 BEAL PKWY NW WAL- MART PHARMACY 10-919
    FORT WALTON BEACH, FL
    ZIP 32547
  • Facility Phone: 850 863-2204
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER ROBERTS
  • NPI Number: 1043237258
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2189492
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 748 BEAL PKWY NW WAL- MART PHARMACY 10-919
City FORT WALTON BEACH
State FL
ZIP 32547
Phone 850 863-2204
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Pharmacy
Lab Director JENNIFER ROBERTS

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