10D2210466 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2210466
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 4520 S SEMORAN BLVD
    ORLANDO, FL
    ZIP 32822
  • Facility Phone: 407 563-7190
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JITENDRA SARASWAT
  • NPI Number: 1407873870
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2210466
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 4520 S SEMORAN BLVD
City ORLANDO
State FL
ZIP 32822
Phone 407 563-7190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2025
Certificate Expiration Date 1/20/2027
Facility Type Pharmacy
Lab Director JITENDRA SARASWAT

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