10D2190933 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2190933
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 12610 US HWY 19
    HUDSON, FL
    ZIP 34667
  • Facility Phone: (727) 861-0050
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELAHEH NAZERI
  • NPI Number: 1194901520
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190933
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 12610 US HWY 19
City HUDSON
State FL
ZIP 34667
Phone 7278610050
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 ELAHEH NAZERI

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