10D2190360 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2190360
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 6850 GULFPORT BLVD S
    PASADENA, FL
    ZIP 33707
  • Facility Phone: 727 202-3877
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FATINA MAKAROVA
  • NPI Number: 1700216116
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2190360
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 6850 GULFPORT BLVD S
City PASADENA
State FL
ZIP 33707
Phone 727 202-3877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Pharmacy
Lab Director FATINA MAKAROVA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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