03D2126899 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4829

Laboratory Demographics

  • CLIA Code: 03D2126899
  • Facility Name: SAM'S CLUB PHARMACY 10-4829
  • Facility Address: 2621 S MARKET ST
    GILBERT, AZ
    ZIP 85295
  • Facility Phone: 480 722-9972
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL WEESE
  • NPI Number: 1851575831
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 03D2126899
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4829
Street 2621 S MARKET ST
City GILBERT
State AZ
ZIP 85295
Phone 480 722-9972
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 MICHAEL WEESE

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This page was last updated on: 9/29/2025