16D2134934 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4973

Laboratory Demographics

  • CLIA Code: 16D2134934
  • Facility Name: SAM'S CLUB PHARMACY 10-4973
  • Facility Address: 4400 ASBURY RD
    DUBUQUE, IA
    ZIP 52002
  • Facility Phone: 563 587-0586
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRIS FROMMELT
  • NPI Number: 1790846830
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 16D2134934
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4973
Street 4400 ASBURY RD
City DUBUQUE
State IA
ZIP 52002
Phone 563 587-0586
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Pharmacy
Lab Director KRIS FROMMELT

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