01D2141408 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8192

Laboratory Demographics

  • CLIA Code: 01D2141408
  • Facility Name: SAM'S CLUB PHARMACY 10-8192
  • Facility Address: 3440 ROSS CLARK CIRCLE
    DOTHAN, AL
    ZIP 36303
  • Facility Phone: 334 671-1327
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELLIOTT CAREY
  • NPI Number: 1689707804
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 01D2141408
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8192
Street 3440 ROSS CLARK CIRCLE
City DOTHAN
State AL
ZIP 36303
Phone 334 671-1327
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2023
Certificate Expiration Date 12/12/2025
Facility Type Pharmacy
Lab Director ELLIOTT CAREY

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