03D2126731 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4915

Laboratory Demographics

CLIA Number: 03D2126731

Facility Name: SAM'S CLUB PHARMACY 10-4915

Facility Address:
600 HIGHWAY 95, STE 200
BULLHEAD CITY, AZ
ZIP 86429
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Facility Phone Number: (928) 754-3961

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1659752145

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	03D2126731
LAB Type	PHARMACY
Facility Name	SAM'S CLUB PHARMACY 10-4915
Street	600 HIGHWAY 95, STE 200
City	BULLHEAD CITY
State	AZ
ZIP	86429
Phone	(928) 754-3961

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