10D2189846 CLIA NUMBER - WAL-MART STORES EAST LP #5366

Laboratory Demographics

  • CLIA Code: 10D2189846
  • Facility Name: WAL-MART STORES EAST LP #5366
  • Facility Address: 3550 S BABCOCK ST
    MELBOURNE, FL
    ZIP 32901
  • Facility Phone: 321 723-8830
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOAN GRANT-CHIN
  • NPI Number: 1306863600
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2189846
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP #5366
Street 3550 S BABCOCK ST
City MELBOURNE
State FL
ZIP 32901
Phone 321 723-8830
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Pharmacy
Lab Director JOAN GRANT-CHIN

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