10D2190785 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2190785
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 12800 PINES BLVD
    PEMBROKE PINES, FL
    ZIP 33027
  • Facility Phone: 954 378-1367
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDER MILETTI
  • NPI Number: 1548547052
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190785
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 12800 PINES BLVD
City PEMBROKE PINES
State FL
ZIP 33027
Phone 954 378-1367
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 ALEXANDER MILETTI

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