21D2143873 CLIA NUMBER - SAMS CLUB PHARMACY 10-6652

Laboratory Demographics

  • CLIA Code: 21D2143873
  • Facility Name: SAMS CLUB PHARMACY 10-6652
  • Facility Address: 5604 BUCKEYSTOWN
    FREDERICK, MD
    ZIP 21704
  • Facility Phone: 240 379-7612
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHA KAUSHIK
  • NPI Number: 1821197351
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 21D2143873
LAB Type Pharmacy
Facility Name SAMS CLUB PHARMACY 10-6652
Street 5604 BUCKEYSTOWN
City FREDERICK
State MD
ZIP 21704
Phone 240 379-7612
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Pharmacy
Lab Director RICHA KAUSHIK

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