10D2189876 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2189876
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 3501 34TH ST SOUTH
    SAINT PETERSBURG, FL
    ZIP 33711
  • Facility Phone: 727 906-4030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GARY A. FREEMAN
  • NPI Number: 1497772792
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2189876
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 3501 34TH ST SOUTH
City SAINT PETERSBURG
State FL
ZIP 33711
Phone 727 906-4030
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 GARY A. FREEMAN

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