15D2133231 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8123

Laboratory Demographics

  • CLIA Code: 15D2133231
  • Facility Name: SAM'S CLUB PHARMACY 10-8123
  • Facility Address: 6700 E VIRGINIA ST
    EVANSVILLE, IN
    ZIP 47715
  • Facility Phone: 812 473-5892
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY BOWMAN
  • NPI Number: 1275620833
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2133231
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8123
Street 6700 E VIRGINIA ST
City EVANSVILLE
State IN
ZIP 47715
Phone 812 473-5892
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Pharmacy
Lab Director AMY BOWMAN

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