14D2133005 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6487

Laboratory Demographics

CLIA Number: 14D2133005

Facility Name: SAM'S CLUB PHARMACY 10-6487

Facility Address:
1006 ROHLWING RD
ADDISON, IL
ZIP 60101
Get Directions

Facility Phone Number: 630 424-0486

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1528329745

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	14D2133005
LAB Type	Pharmacy
Facility Name	SAM'S CLUB PHARMACY 10-6487
Street	1006 ROHLWING RD
City	ADDISON
State	IL
ZIP	60101
Phone	630 424-0486
CertificateType	4
CertificateEffectiveDate	7/3/2023
CertificateExpirationDate	7/2/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024