16D2134352 CLIA NUMBER - SAMS CLUB PHARMACY 10-6979

Laboratory Demographics

  • CLIA Code: 16D2134352
  • Facility Name: SAMS CLUB PHARMACY 10-6979
  • Facility Address: 4625 SE DELAWARE AVENUE
    ANKENY, IA
    ZIP 50021
  • Facility Phone: 515 559-1995
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KERI MICHEL
  • NPI Number: 1245623016
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 16D2134352
LAB Type Pharmacy
Facility Name SAMS CLUB PHARMACY 10-6979
Street 4625 SE DELAWARE AVENUE
City ANKENY
State IA
ZIP 50021
Phone 515 559-1995
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2025
Certificate Expiration Date 7/31/2027
Facility Type Pharmacy
Lab Director KERI MICHEL

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