10D2191838 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2191838
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 3175 CHENEY HWY
    TITUSVILLE, FL
    ZIP 32780
  • Facility Phone: 321 268-5020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL QUINN
  • NPI Number: 1043237357
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2191838
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 3175 CHENEY HWY
City TITUSVILLE
State FL
ZIP 32780
Phone 321 268-5020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Pharmacy
Lab Director DANIEL QUINN

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