10D2297876 CLIA NUMBER - COSTCO WHOLESALE CORPORATION

Laboratory Demographics

  • CLIA Code: 10D2297876
  • Facility Name: COSTCO WHOLESALE CORPORATION
  • Facility Address: 150 PIT RD
    DAYTONA BEACH, FL
    ZIP 32114
  • Facility Phone: 425 416-1859
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY THOMAS FREEMAN
  • NPI Number: 1063281186
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 10D2297876
LAB Type Pharmacy
Facility Name COSTCO WHOLESALE CORPORATION
Street 150 PIT RD
City DAYTONA BEACH
State FL
ZIP 32114
Phone 425 416-1859
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Pharmacy
Lab Director CASEY THOMAS FREEMAN

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