10D2190136 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2190136
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 11110 CAUSEWAY BLVD
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 813 661-4426
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE HUYNH
  • NPI Number: 1124045513
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190136
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 11110 CAUSEWAY BLVD
City BRANDON
State FL
ZIP 33511
Phone 813 661-4426
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Pharmacy
Lab Director MICHELLE HUYNH

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