20D2126128 CLIA NUMBER - SAM'S EAST, INC SAM'S PHARMACY 108186

Laboratory Demographics

  • CLIA Code: 20D2126128
  • Facility Name: SAM'S EAST, INC SAM'S PHARMACY 108186
  • Facility Address: 440 PAYNE ROAD
    SCARBOROUGH, ME
    ZIP 04074
  • Facility Phone: 207 883-3617
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON P. LANCASTER
  • NPI Number: 1144483520
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2126128
LAB Type Pharmacy
Facility Name SAM'S EAST, INC SAM'S PHARMACY 108186
Street 440 PAYNE ROAD
City SCARBOROUGH
State ME
ZIP 04074
Phone 207 883-3617
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 BRANDON P. LANCASTER

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