10D2190899 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2190899
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 4965 HIGHWAY 90
    MILTON, FL
    ZIP 32571
  • Facility Phone: (850) 995-5115
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRISTAN COX
  • NPI Number: 1124045331
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190899
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 4965 HIGHWAY 90
City MILTON
State FL
ZIP 32571
Phone 8509955115
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Pharmacy
Lab Director TRISTAN COX

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This page was last updated on: 5/18/2026