10D2190971 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2190971
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 2850 E OSCEOLA PARKWAY
    KISSIMMEE, FL
    ZIP 34743
  • Facility Phone: 407 552-0036
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAMIRO ROMAN
  • NPI Number: 1194135947
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2190971
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 2850 E OSCEOLA PARKWAY
City KISSIMMEE
State FL
ZIP 34743
Phone 407 552-0036
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2024
Certificate Expiration Date 8/20/2026
Facility Type Pharmacy
Lab Director RAMIRO ROMAN

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