10D2191069 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2191069
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 3155 SOUTH FEDERAL HIGHWAY
    DELRAY BEACH, FL
    ZIP 33483
  • Facility Phone: 561 450-3021
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANANYA AMIN
  • NPI Number: 1962832386
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2191069
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 3155 SOUTH FEDERAL HIGHWAY
City DELRAY BEACH
State FL
ZIP 33483
Phone 561 450-3021
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 ANANYA AMIN

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