10D2191125 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2191125
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 1885 N PINE ISLAND RD
    PLANTATION, FL
    ZIP 33322
  • Facility Phone: 954 472-3305
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REZA RAHEMI
  • NPI Number: 1548660749
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 10D2191125
LAB Type Physician Office
Facility Name WAL-MART STORES EAST, LP
Street 1885 N PINE ISLAND RD
City PLANTATION
State FL
ZIP 33322
Phone 954 472-3305
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 Physician Office
Lab Director REZA RAHEMI

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