10D2190144 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2190144
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 14941 N DALE MABRY HWY
    TAMPA, FL
    ZIP 33618
  • Facility Phone: 813 265-8870
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAL DIMARCO
  • NPI Number: 1689691065
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190144
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 14941 N DALE MABRY HWY
City TAMPA
State FL
ZIP 33618
Phone 813 265-8870
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 SAL DIMARCO

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