10D2291074 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

  • CLIA Code: 10D2291074
  • Facility Name: WAL-MART STORES EAST, LP
  • Facility Address: 1239 STATE RD 436 STE 101
    CASSELBERRY, FL
    ZIP 32707
  • Facility Phone: (407) 679-0373
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SYLMARIE B. MIRANDA
  • NPI Number: 1942227152
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2291074
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP
Street 1239 STATE RD 436 STE 101
City CASSELBERRY
State FL
ZIP 32707
Phone 4076790373
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type Pharmacy
Lab Director SYLMARIE B. MIRANDA

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This page was last updated on: 5/18/2026