10D2279486 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2279486
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 9131 COLLEGE PKWY STE 101
    FORT MYERS, FL
    ZIP 33919
  • Facility Phone: 239 267-2032
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMEER MANIKTALA
  • NPI Number: 1790966307
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2279486
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 9131 COLLEGE PKWY STE 101
City FORT MYERS
State FL
ZIP 33919
Phone 239 267-2032
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Pharmacy
Lab Director SAMEER MANIKTALA

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