10D2191086 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2191086
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 13140 S TAMIAMI TRAIL
    OSPREY, FL
    ZIP 34229
  • Facility Phone: 702 885-2708
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HARSHILRAJA M. PATEL
  • NPI Number: 1073531406
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2191086
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 13140 S TAMIAMI TRAIL
City OSPREY
State FL
ZIP 34229
Phone 702 885-2708
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Pharmacy
Lab Director HARSHILRAJA M. PATEL

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