04D2126181 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8266 SAM'S WEST, INC

Laboratory Demographics

  • CLIA Code: 04D2126181
  • Facility Name: SAM'S CLUB PHARMACY 10-8266 SAM'S WEST, INC
  • Facility Address: 5600 LANDERS ROAD
    SHERWOOD, AR
    ZIP 72117
  • Facility Phone: 501 955-9451
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER MAINALI
  • NPI Number: 1417030941
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 04D2126181
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8266 SAM'S WEST, INC
Street 5600 LANDERS ROAD
City SHERWOOD
State AR
ZIP 72117
Phone 501 955-9451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Pharmacy
Lab Director JENNIFER MAINALI

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