17D2143936 CLIA NUMBER - SAM'S CLUB PHARMACY #8254

Laboratory Demographics

  • CLIA Code: 17D2143936
  • Facility Name: SAM'S CLUB PHARMACY #8254
  • Facility Address: 6200 W KELLOGG DR
    WICHITA, KS
    ZIP 67209
  • Facility Phone: 316 941-4427
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDA I. SMITH
  • NPI Number: 1831287457
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 17D2143936
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY #8254
Street 6200 W KELLOGG DR
City WICHITA
State KS
ZIP 67209
Phone 316 941-4427
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Pharmacy
Lab Director LINDA I. SMITH

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