10D2196070 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2196070
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 4536 53RD AVE E
    BRADENTON, FL
    ZIP 34203
  • Facility Phone: 941 213-6910
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH SAMUEL WILLIAMS
  • NPI Number: 1619336914
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2196070
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 4536 53RD AVE E
City BRADENTON
State FL
ZIP 34203
Phone 941 213-6910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Pharmacy
Lab Director JOSEPH SAMUEL WILLIAMS

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