17D2135475 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4870

Laboratory Demographics

  • CLIA Code: 17D2135475
  • Facility Name: SAM'S CLUB PHARMACY 10-4870
  • Facility Address: 10510 PARALLEL PKWY
    KANSAS CITY, KS
    ZIP 66109
  • Facility Phone: 913 693-0984
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE S. GETTLER
  • NPI Number: 1932459229
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 17D2135475
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4870
Street 10510 PARALLEL PKWY
City KANSAS CITY
State KS
ZIP 66109
Phone 913 693-0984
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Pharmacy
Lab Director STEPHANIE S. GETTLER

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