15D2133239 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4851

Laboratory Demographics

  • CLIA Code: 15D2133239
  • Facility Name: SAM'S CLUB PHARMACY 10-4851
  • Facility Address: 1301 VETERANS PKWY
    CLARKSVILLE, IN
    ZIP 47129
  • Facility Phone: 812 218-0447
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANNA INGLE
  • NPI Number: 1598856973
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2133239
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4851
Street 1301 VETERANS PKWY
City CLARKSVILLE
State IN
ZIP 47129
Phone 812 218-0447
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 ANNA INGLE

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