14D2133010 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6358

Laboratory Demographics

CLIA Number: 14D2133010

Facility Name: SAM'S CLUB PHARMACY 10-6358

Facility Address:
141 W NORTH AVE
NORTHLAKE, IL
ZIP 60164
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Facility Phone Number: 708 492-1417

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1295835312

Taxonomy: 156FX1800X - Technician/Technologist
Opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy.

CLIA Record

Field Name	Field Value
CLIA Number	14D2133010
LAB Type	Pharmacy
Facility Name	SAM'S CLUB PHARMACY 10-6358
Street	141 W NORTH AVE
City	NORTHLAKE
State	IL
ZIP	60164
Phone	708 492-1417
CertificateType	4
CertificateEffectiveDate	7/3/2023
CertificateExpirationDate	7/2/2025
FacilityType	Waiver

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