10D2190698 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2190698
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 9890 HUTCHINSON PARK DR WALMART PHARMACY 10-1444
    JACKSONVILLE, FL
    ZIP 32225
  • Facility Phone: 904 721-4699
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK CHIEDO
  • NPI Number: 1316964794
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190698
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 9890 HUTCHINSON PARK DR WALMART PHARMACY 10-1444
City JACKSONVILLE
State FL
ZIP 32225
Phone 904 721-4699
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 MARK CHIEDO

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