15D2133208 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8135

Laboratory Demographics

  • CLIA Code: 15D2133208
  • Facility Name: SAM'S CLUB PHARMACY 10-8135
  • Facility Address: 4350 S US HIGHWAY 41
    TERRE HAUTE, IN
    ZIP 47802
  • Facility Phone: 812 238-5572
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MEGAN PATRICH
  • NPI Number: 1841387354
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2133208
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8135
Street 4350 S US HIGHWAY 41
City TERRE HAUTE
State IN
ZIP 47802
Phone 812 238-5572
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2025
Certificate Expiration Date 7/6/2027
Facility Type Pharmacy
Lab Director MEGAN PATRICH

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