10D2191445 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2191445
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 3101 W PRINCETON ST
    ORLANDO, FL
    ZIP 32808
  • Facility Phone: 407 445-4047
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIA L. ANDERSON
  • NPI Number: 1558692046
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2191445
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 3101 W PRINCETON ST
City ORLANDO
State FL
ZIP 32808
Phone 407 445-4047
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type Pharmacy
Lab Director TIA L. ANDERSON

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