10D2275960 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2275960
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 5315 CORTEZ RD
    BRADENTON, FL
    ZIP 34210
  • Facility Phone: 941 795-1807
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHANTELE PAQUIN
  • NPI Number: 1063439438
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2275960
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 5315 CORTEZ RD
City BRADENTON
State FL
ZIP 34210
Phone 941 795-1807
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Pharmacy
Lab Director CHANTELE PAQUIN

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