10D2190285 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2190285
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 2701 E FLETCHER AVE
    TAMPA, FL
    ZIP 33612
  • Facility Phone: 813 558-0383
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMIE MORANCY
  • NPI Number: 1669499059
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190285
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 2701 E FLETCHER AVE
City TAMPA
State FL
ZIP 33612
Phone 813 558-0383
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Pharmacy
Lab Director JAMIE MORANCY

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