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: 1972694131

Taxonomy: 156FX1800X - Technician/Technologist

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: 4/7/2021