10D2275599 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2275599
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 6855 WILSON BLVD
    JACKSONVILLE, FL
    ZIP 32210
  • Facility Phone: 904 513-6627
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHEAL COATES
  • NPI Number: 1528475597
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2275599
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 6855 WILSON BLVD
City JACKSONVILLE
State FL
ZIP 32210
Phone 904 513-6627
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Pharmacy
Lab Director MICHEAL COATES

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