10D2191101 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2191101
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 955 S WOODLAND BOULEVARD
    DELAND, FL
    ZIP 32724
  • Facility Phone: 386 624-0679
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID BARNARD
  • NPI Number: 1720506967
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2191101
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 955 S WOODLAND BOULEVARD
City DELAND
State FL
ZIP 32724
Phone 386 624-0679
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 DAVID BARNARD

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