03D2126895 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6213

Laboratory Demographics

  • CLIA Code: 03D2126895
  • Facility Name: SAM'S CLUB PHARMACY 10-6213
  • Facility Address: 700 N 54TH ST
    CHANDLER, AZ
    ZIP 85226
  • Facility Phone: 480 893-6999
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HEMANTHA N. KESAVADAS
  • NPI Number: 1457442998
  • Taxonomy: 156FX1800X - Technician/Technologist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2126895
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6213
Street 700 N 54TH ST
City CHANDLER
State AZ
ZIP 85226
Phone 480 893-6999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2025
Certificate Expiration Date 3/6/2027
Facility Type Pharmacy
Lab Director HEMANTHA N. KESAVADAS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025