10D2201751 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2201751
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 2500 S KIRKMAN RD
    ORLANDO, FL
    ZIP 32811
  • Facility Phone: 407 297-9785
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NGOC LUU
  • NPI Number: 1417974890
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2201751
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 2500 S KIRKMAN RD
City ORLANDO
State FL
ZIP 32811
Phone 407 297-9785
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2024
Certificate Expiration Date 11/22/2026
Facility Type Pharmacy
Lab Director NGOC LUU

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