10D2193963 CLIA NUMBER - WAL-MART STORE EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2193963
  • Facility Name: WAL-MART STORE EAST, LP
  • Facility Address: 13490 BEACH BLVD
    JACKSONVILLE, FL
    ZIP 32224
  • Facility Phone: (904) 223-0722
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALAN DOBRITCH
  • NPI Number: 1497772867
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2193963
LAB Type Pharmacy
Facility Name WAL-MART STORE EAST, LP
Street 13490 BEACH BLVD
City JACKSONVILLE
State FL
ZIP 32224
Phone 9042230722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Pharmacy
Lab Director ALAN DOBRITCH

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: 5/18/2026