19D2133605 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8181

Laboratory Demographics

  • CLIA Code: 19D2133605
  • Facility Name: SAM'S CLUB PHARMACY 10-8181
  • Facility Address: 3805 NORTH BLVD
    ALEXANDRIA, LA
    ZIP 71301
  • Facility Phone: 318 442-9505
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RODNEY W. LEWIS
  • NPI Number: 1427287630
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 19D2133605
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8181
Street 3805 NORTH BLVD
City ALEXANDRIA
State LA
ZIP 71301
Phone 318 442-9505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2025
Certificate Expiration Date 7/16/2027
Facility Type Pharmacy
Lab Director RODNEY W. LEWIS

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