10D2191368 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2191368
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 19910 BRUCE B DOWNS BLVD
    TAMPA, FL
    ZIP 33647
  • Facility Phone: 224 436-7398
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BHAKTIBEN PATEL
  • NPI Number: 1215954615
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2191368
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 19910 BRUCE B DOWNS BLVD
City TAMPA
State FL
ZIP 33647
Phone 224 436-7398
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Pharmacy
Lab Director BHAKTIBEN PATEL

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