10D2276391 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

  • CLIA Code: 10D2276391
  • Facility Name: WAL-MART STORES EAST LP
  • Facility Address: 2911 53RD AVE E WALMART PHARMACY #10-528
    BRADEN RIVER, FL
    ZIP 34203
  • Facility Phone: 941 753-6764
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID PADRON
  • NPI Number: 1871510180
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2276391
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP
Street 2911 53RD AVE E WALMART PHARMACY #10-528
City BRADEN RIVER
State FL
ZIP 34203
Phone 941 753-6764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Pharmacy
Lab Director DAVID PADRON

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