10D2279556 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2279556
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 3920 SKYLINE BLVD
    CAPE CORAL, FL
    ZIP 33914
  • Facility Phone: 239 540-2460
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEREMIAH YOUNGBLOOD
  • NPI Number: 1508883810
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2279556
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 3920 SKYLINE BLVD
City CAPE CORAL
State FL
ZIP 33914
Phone 239 540-2460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Pharmacy
Lab Director JEREMIAH YOUNGBLOOD

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