01D2146172 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4776

Laboratory Demographics

  • CLIA Code: 01D2146172
  • Facility Name: SAM'S CLUB PHARMACY 10-4776
  • Facility Address: 5651 HOLMES AVE NW
    HUNTSVILLE, AL
    ZIP 35816
  • Facility Phone: 256 837-7212
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE E. MAPLES
  • NPI Number: 1306933809
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 01D2146172
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4776
Street 5651 HOLMES AVE NW
City HUNTSVILLE
State AL
ZIP 35816
Phone 256 837-7212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Pharmacy
Lab Director STEPHANIE E. MAPLES

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