10D2190221 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2190221
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 1450 JOHNS LAKE RD
    CLERMONT, FL
    ZIP 34711
  • Facility Phone: 352 243-6270
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMIE LEVANGIE
  • NPI Number: 1982622312
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190221
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 1450 JOHNS LAKE RD
City CLERMONT
State FL
ZIP 34711
Phone 352 243-6270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Pharmacy
Lab Director JAMIE LEVANGIE

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