15D2133252 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8168

Laboratory Demographics

  • CLIA Code: 15D2133252
  • Facility Name: SAM'S CLUB PHARMACY 10-8168
  • Facility Address: 7235 E 96TH ST
    INDIANAPOLIS, IN
    ZIP 46250
  • Facility Phone: 317 585-9387
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIANNE MAKAR
  • NPI Number: 1649367905
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2133252
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8168
Street 7235 E 96TH ST
City INDIANAPOLIS
State IN
ZIP 46250
Phone 317 585-9387
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 MARIANNE MAKAR

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