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

Laboratory Demographics

  • CLIA Code: 14D2133005
  • Facility Name: SAM'S CLUB PHARMACY 10-6487
  • Facility Address: 1006 ROHLWING RD
    ADDISON, IL
    ZIP 60101
  • Facility Phone: 630 424-0486
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMARTH BRAHMBHATT
  • NPI Number: 1528329745
  • Taxonomy: 332H00000X - Eyewear Supplier

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2025
Certificate Expiration Date 7/2/2027
Facility Type Pharmacy
Lab Director SAMARTH BRAHMBHATT

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