10D2291200 CLIA NUMBER - COSTCO WHOLESALE CORPORATION

Laboratory Demographics

  • CLIA Code: 10D2291200
  • Facility Name: COSTCO WHOLESALE CORPORATION
  • Facility Address: 4600 COLLINA TERRACE
    CLERMONT, FL
    ZIP 34711
  • Facility Phone: 689 407-3673
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JODI L. CARLSON
  • NPI Number: 1942980974
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2291200
LAB Type Pharmacy
Facility Name COSTCO WHOLESALE CORPORATION
Street 4600 COLLINA TERRACE
City CLERMONT
State FL
ZIP 34711
Phone 689 407-3673
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2025
Certificate Expiration Date 10/5/2027
Facility Type Pharmacy
Lab Director JODI L. CARLSON

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