10D2190774 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2190774
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 10635 W ATLANTIC BLVD
    CORAL SPRINGS, FL
    ZIP 33071
  • Facility Phone: 954 345-9250
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAMIN RAHEMI
  • NPI Number: 1265640130
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190774
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 10635 W ATLANTIC BLVD
City CORAL SPRINGS
State FL
ZIP 33071
Phone 954 345-9250
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 RAMIN RAHEMI

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