36D2175525 CLIA NUMBER - WALMART PHARMACY 10-1863

Laboratory Demographics

  • CLIA Code: 36D2175525
  • Facility Name: WALMART PHARMACY 10-1863
  • Facility Address: 33752 VINE ST
    EASTLAKE, OH
    ZIP 44095
  • Facility Phone: 440 269-8828
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER LATTANZIO
  • NPI Number: 1649297839
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2175525
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1863
Street 33752 VINE ST
City EASTLAKE
State OH
ZIP 44095
Phone 440 269-8828
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type Pharmacy
Lab Director CHRISTOPHER LATTANZIO

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