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03D2126729 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6604

Laboratory Demographics

CLIA Number: 03D2126729

Facility Name: SAM'S CLUB PHARMACY 10-6604

Facility Address:
1851 E BUTLER AVE
FLAGSTAFF, AZ
ZIP 86001
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Facility Phone Number: (928) 774-3293

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1740379627

Taxonomy: 156FX1800X - Technician/Technologist

CLIA Record

Field Name Field Value
CLIA Number 03D2126729
LAB Type PHARMACY
Facility Name SAM'S CLUB PHARMACY 10-6604
Street 1851 E BUTLER AVE
City FLAGSTAFF
State AZ
ZIP 86001
Phone (928) 774-3293

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This page was last updated on: 5/11/2023