10D2211475 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2211475
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 2461 E GULF TO LAKE HWY
    INVERNESS, FL
    ZIP 34453
  • Facility Phone: 352 637-2300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SASIRA MALIREDDY-KONALA
  • NPI Number: 1134229032
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 10D2211475
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 2461 E GULF TO LAKE HWY
City INVERNESS
State FL
ZIP 34453
Phone 352 637-2300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Pharmacy
Lab Director SASIRA MALIREDDY-KONALA

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