14D2133034 CLIA NUMBER - SAM'S CLUB PHARMACY #4942

Laboratory Demographics

  • CLIA Code: 14D2133034
  • Facility Name: SAM'S CLUB PHARMACY #4942
  • Facility Address: 1000 S RANDALL RD
    ELGIN, IL
    ZIP 60123
  • Facility Phone: 630 503-2148
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NILESHKUMAR PATEL
  • NPI Number: 1215291364
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2133034
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY #4942
Street 1000 S RANDALL RD
City ELGIN
State IL
ZIP 60123
Phone 630 503-2148
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 NILESHKUMAR PATEL

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