10D2189770 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2189770
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 2400 VETERANS MEMORIAL PKWY
    ORANGE CITY, FL
    ZIP 32763
  • Facility Phone: 386 775-4844
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN HUYNH
  • NPI Number: 1245257740
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2189770
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 2400 VETERANS MEMORIAL PKWY
City ORANGE CITY
State FL
ZIP 32763
Phone 386 775-4844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type Pharmacy
Lab Director KEVIN HUYNH

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