10D2189909 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2189909
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 36205 US HWY 27
    HAINES CITY, FL
    ZIP 33844
  • Facility Phone: 863 422-7582
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LUZZETTE RIVERA
  • NPI Number: 1326066754
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2189909
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 36205 US HWY 27
City HAINES CITY
State FL
ZIP 33844
Phone 863 422-7582
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2024
Certificate Expiration Date 8/6/2026
Facility Type Pharmacy
Lab Director LUZZETTE RIVERA

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