17D2137928 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8176

Laboratory Demographics

  • CLIA Code: 17D2137928
  • Facility Name: SAM'S CLUB PHARMACY 10-8176
  • Facility Address: 1401 SW WANAMAKER RD
    TOPEKA, KS
    ZIP 66604
  • Facility Phone: 785 228-2672
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL E. BRUNGARDT
  • NPI Number: 1376624049
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2137928
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8176
Street 1401 SW WANAMAKER RD
City TOPEKA
State KS
ZIP 66604
Phone 785 228-2672
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2025
Certificate Expiration Date 10/5/2027
Facility Type Pharmacy
Lab Director PAUL E. BRUNGARDT

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