03D2126734 CLIA NUMBER - Sam's Club Pharmacy 10-4955

Laboratory Demographics

CLIA Number: 03D2126734

Facility Name: Sam's Club Pharmacy 10-4955

Facility Address:
16573 W Bell Rd
Surprise, AZ
ZIP 85374
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Facility Phone Number: (623) 584-0728

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1689810533

Taxonomy: 156FX1800X - Technician/Technologist

CLIA Record

Field Name Field Value
CLIA Number 03D2126734
LAB Type PHARMACY
Facility Name Sam's Club Pharmacy 10-4955
Street 16573 W Bell Rd
City Surprise
State AZ
ZIP 85374
Phone (623) 584-0728

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