15D2133256 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4926

Laboratory Demographics

  • CLIA Code: 15D2133256
  • Facility Name: SAM'S CLUB PHARMACY 10-4926
  • Facility Address: 2715 MERCHANT MILE
    COLUMBUS, IN
    ZIP 47201
  • Facility Phone: 812 373-9273
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WADE D. SHEPHERD
  • NPI Number: 1407957681
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2133256
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4926
Street 2715 MERCHANT MILE
City COLUMBUS
State IN
ZIP 47201
Phone 812 373-9273
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 WADE D. SHEPHERD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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