10D2191454 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2191454
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 4525 GUNN HWY
    TAMPA, FL
    ZIP 33624
  • Facility Phone: 813 261-6088
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JORGE MENDEZ
  • NPI Number: 1336551407
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2191454
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 4525 GUNN HWY
City TAMPA
State FL
ZIP 33624
Phone 813 261-6088
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 JORGE MENDEZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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