10D2219340 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2219340
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 1101 S GOLDWYN
    ORLANDO, FL
    ZIP 32805
  • Facility Phone: 407 563-9147
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALNITA K. SHAW
  • NPI Number: 1467898882
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2219340
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 1101 S GOLDWYN
City ORLANDO
State FL
ZIP 32805
Phone 407 563-9147
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director ALNITA K. SHAW

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