14D2133006 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6464

Laboratory Demographics

  • CLIA Code: 14D2133006
  • Facility Name: SAM'S CLUB PHARMACY 10-6464
  • Facility Address: 101 W OAKTON ST
    DES PLAINES, IL
    ZIP 60018
  • Facility Phone: 847 803-0181
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN J. SEYBOLD
  • NPI Number: 1306947361
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2133006
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6464
Street 101 W OAKTON ST
City DES PLAINES
State IL
ZIP 60018
Phone 847 803-0181
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 JOHN J. SEYBOLD

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