10D2192024 CLIA NUMBER - WALMART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2192024
  • Facility Name: WALMART STORES EAST LP
  • Facility Address: 185 N CHARLES RICHCARD BELL BOULEVARD
    DEBARY, FL
    ZIP 32713
  • Facility Phone: 386 601-0036
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RUCHITA PATEL
  • NPI Number: 1003363052
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2192024
LAB Type Pharmacy
Facility Name WALMART STORES EAST LP
Street 185 N CHARLES RICHCARD BELL BOULEVARD
City DEBARY
State FL
ZIP 32713
Phone 386 601-0036
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Pharmacy
Lab Director RUCHITA PATEL

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