10D2179273 CLIA NUMBER - SAMS CLUB PHARMACY 10-6387

Laboratory Demographics

  • CLIA Code: 10D2179273
  • Facility Name: SAMS CLUB PHARMACY 10-6387
  • Facility Address: 7001 PARK BLVD
    PINELLAS PARK, FL
    ZIP 33781
  • Facility Phone: 727 547-6411
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HADLEY REVELL
  • NPI Number: 1366540346
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 10D2179273
LAB Type Pharmacy
Facility Name SAMS CLUB PHARMACY 10-6387
Street 7001 PARK BLVD
City PINELLAS PARK
State FL
ZIP 33781
Phone 727 547-6411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2024
Certificate Expiration Date 2/18/2026
Facility Type Pharmacy
Lab Director HADLEY REVELL

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