10D2190728 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2190728
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 16313 NEW INDEPENDENCE PARKWAY
    WINTER GARDEN, FL
    ZIP 34787
  • Facility Phone: 407 554-0181
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LYSANDRA MERCADO
  • NPI Number: 1073060646
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190728
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 16313 NEW INDEPENDENCE PARKWAY
City WINTER GARDEN
State FL
ZIP 34787
Phone 407 554-0181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Pharmacy
Lab Director LYSANDRA MERCADO

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