03D2126723 CLIA NUMBER - Sam's Club Pharmacy 10-4830

Laboratory Demographics

CLIA Number: 03D2126723

Facility Name: Sam's Club Pharmacy 10-4830

Facility Address:
1459 N Dysart Rd
Avondale, AZ
ZIP 85323
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Facility Phone Number: (623) 882-3871

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1508957721

Taxonomy: 156FX1800X - Technician/Technologist

CLIA Record

Field Name Field Value
CLIA Number 03D2126723
LAB Type PHARMACY
Facility Name Sam's Club Pharmacy 10-4830
Street 1459 N Dysart Rd
City Avondale
State AZ
ZIP 85323
Phone (623) 882-3871

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This page was last updated on: 4/7/2021