18D2126752 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8133

Laboratory Demographics

  • CLIA Code: 18D2126752
  • Facility Name: SAM'S CLUB PHARMACY 10-8133
  • Facility Address: 4949 HOUSTON RD
    FLORENCE, KY
    ZIP 41042
  • Facility Phone: 479 204-2258
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY LEWIS
  • NPI Number: 1023100559
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 18D2126752
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8133
Street 4949 HOUSTON RD
City FLORENCE
State KY
ZIP 41042
Phone 479 204-2258
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Pharmacy
Lab Director KELLY LEWIS

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