19D2135603 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8273

Laboratory Demographics

  • CLIA Code: 19D2135603
  • Facility Name: SAM'S CLUB PHARMACY 10-8273
  • Facility Address: 7400 YOUREE DRIVE
    SHREVEPORT, LA
    ZIP 71105
  • Facility Phone: 318 798-0566
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES W. SOUTHERN
  • NPI Number: 1326137209
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D2135603
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8273
Street 7400 YOUREE DRIVE
City SHREVEPORT
State LA
ZIP 71105
Phone 318 798-0566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Pharmacy
Lab Director JAMES W. SOUTHERN

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