19D2133608 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4874

Laboratory Demographics

  • CLIA Code: 19D2133608
  • Facility Name: SAM'S CLUB PHARMACY 10-4874
  • Facility Address: 69630 STIRLING BLVD
    COVINGTON, LA
    ZIP 70433
  • Facility Phone: 985 327-6261
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DUY NGUYEN
  • NPI Number: 1043560352
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 19D2133608
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4874
Street 69630 STIRLING BLVD
City COVINGTON
State LA
ZIP 70433
Phone 985 327-6261
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 DUY NGUYEN

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