10D2191135 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2191135
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 15017 EMERAL COAST PKWY
    DESTIN, FL
    ZIP 32541
  • Facility Phone: 850 654-1502
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIANNE DEVORE
  • NPI Number: 1053338434
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2191135
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 15017 EMERAL COAST PKWY
City DESTIN
State FL
ZIP 32541
Phone 850 654-1502
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 MARIANNE DEVORE

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