10D2286224 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2286224
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 7450 CYPRESS GARDENS BLVD
    WINTER HAVEN, FL
    ZIP 33884
  • Facility Phone: 863 318-0252
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER VAN RYSWYK
  • NPI Number: 1053338368
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2286224
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 7450 CYPRESS GARDENS BLVD
City WINTER HAVEN
State FL
ZIP 33884
Phone 863 318-0252
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Pharmacy
Lab Director JENNIFER VAN RYSWYK

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