20D2126125 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S PHARMACY 10-6333

Laboratory Demographics

  • CLIA Code: 20D2126125
  • Facility Name: SAM'S EAST, INC DBA SAM'S PHARMACY 10-6333
  • Facility Address: 47 HASKELL ROAD
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 945-9723
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN E. RIPLEY
  • NPI Number: 1457378721
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2126125
LAB Type Pharmacy
Facility Name SAM'S EAST, INC DBA SAM'S PHARMACY 10-6333
Street 47 HASKELL ROAD
City BANGOR
State ME
ZIP 04401
Phone 207 945-9723
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Pharmacy
Lab Director JUSTIN E. RIPLEY

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