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