10D2192625 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2192625
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 3911 S JOG RD
    GREENACRES, FL
    ZIP 33467
  • Facility Phone: 561 964-6467
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MERLY DIAZ
  • NPI Number: 1861637902
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2192625
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 3911 S JOG RD
City GREENACRES
State FL
ZIP 33467
Phone 561 964-6467
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2024
Certificate Expiration Date 9/10/2026
Facility Type Pharmacy
Lab Director MERLY DIAZ

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