10D2191067 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2191067
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 3625 S FEDERAL HWY
    BOYNTON BEACH, FL
    ZIP 33435
  • Facility Phone: 561 600-3095
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINEAU VILSON
  • NPI Number: 1184904351
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2191067
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 3625 S FEDERAL HWY
City BOYNTON BEACH
State FL
ZIP 33435
Phone 561 600-3095
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 LINEAU VILSON

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