10D2189885 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2189885
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 1041 US HWY 27 NORTH
    AVON PARK, FL
    ZIP 33825
  • Facility Phone: 863 452-5159
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRINCESS SCUTT
  • NPI Number: 1851573588
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2189885
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 1041 US HWY 27 NORTH
City AVON PARK
State FL
ZIP 33825
Phone 863 452-5159
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 PRINCESS SCUTT

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