10D2190625 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2190625
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 6670 MOBILE HIGHWAY
    PENSACOLA, FL
    ZIP 32526
  • Facility Phone: 850 483-6175
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLUWATOBI AJIBOLA
  • NPI Number: 1477971380
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190625
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 6670 MOBILE HIGHWAY
City PENSACOLA
State FL
ZIP 32526
Phone 850 483-6175
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Pharmacy
Lab Director OLUWATOBI AJIBOLA

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