10D2192083 CLIA NUMBER - WAL-MART STORES EAST LP WALMART PHARMACY 10-5623

Laboratory Demographics

  • CLIA Code: 10D2192083
  • Facility Name: WAL-MART STORES EAST LP WALMART PHARMACY 10-5623
  • Facility Address: 334 GULF BREEZE PKWY
    GULF BREEZE, FL
    ZIP 32561
  • Facility Phone: 850 733-5069
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC TEEL
  • NPI Number: 1619247079
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2192083
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP WALMART PHARMACY 10-5623
Street 334 GULF BREEZE PKWY
City GULF BREEZE
State FL
ZIP 32561
Phone 850 733-5069
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2024
Certificate Expiration Date 9/3/2026
Facility Type Pharmacy
Lab Director ERIC TEEL

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