10D2211962 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2211962
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 6901 OKEECHOBEE BLVD
    WEST PALM BEACH, FL
    ZIP 33411
  • Facility Phone: 561 683-6909
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELLEN MARTIN-COOPER
  • NPI Number: 1558528059
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2211962
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 6901 OKEECHOBEE BLVD
City WEST PALM BEACH
State FL
ZIP 33411
Phone 561 683-6909
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2025
Certificate Expiration Date 2/1/2027
Facility Type Pharmacy
Lab Director ELLEN MARTIN-COOPER

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