10D2172442 CLIA NUMBER - SAMS CLUB PHARMACY #10-8253

Laboratory Demographics

  • CLIA Code: 10D2172442
  • Facility Name: SAMS CLUB PHARMACY #10-8253
  • Facility Address: 300 BUSCH DRIVE
    JACKSONVILLE, FL
    ZIP 32218
  • Facility Phone: 904 757-7208
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AYMAN SALIB
  • NPI Number: 1639270960
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 10D2172442
LAB Type Pharmacy
Facility Name SAMS CLUB PHARMACY #10-8253
Street 300 BUSCH DRIVE
City JACKSONVILLE
State FL
ZIP 32218
Phone 904 757-7208
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type Pharmacy
Lab Director AYMAN SALIB

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