10D2189863 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2189863
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 17961 S US HIGHWAY 441
    SUMMERFIELD, FL
    ZIP 34491
  • Facility Phone: 352 307-4410
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AFM ALAUDDIN BHUFYAN
  • NPI Number: 1104843598
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2189863
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 17961 S US HIGHWAY 441
City SUMMERFIELD
State FL
ZIP 34491
Phone 352 307-4410
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 AFM ALAUDDIN BHUFYAN

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