10D2174551 CLIA NUMBER - SAMS CLUB PHARMACY #10-8173

Laboratory Demographics

  • CLIA Code: 10D2174551
  • Facility Name: SAMS CLUB PHARMACY #10-8173
  • Facility Address: 1900 S UNIVERSITY DR
    MIRAMAR, FL
    ZIP 33025
  • Facility Phone: 954 436-5635
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GENEVIEVE IBISI
  • NPI Number: 1487745766
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 10D2174551
LAB Type Pharmacy
Facility Name SAMS CLUB PHARMACY #10-8173
Street 1900 S UNIVERSITY DR
City MIRAMAR
State FL
ZIP 33025
Phone 954 436-5635
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type Pharmacy
Lab Director GENEVIEVE IBISI

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