21D2143875 CLIA NUMBER - SAMS CLUB PHARMACY 10-8193

Laboratory Demographics

  • CLIA Code: 21D2143875
  • Facility Name: SAMS CLUB PHARMACY 10-8193
  • Facility Address: 1700 WESEL BOULEVARD
    HAGERSTOWN, MD
    ZIP 21740
  • Facility Phone: 301 393-3786
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TE LIM
  • NPI Number: 1811088198
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 21D2143875
LAB Type Pharmacy
Facility Name SAMS CLUB PHARMACY 10-8193
Street 1700 WESEL BOULEVARD
City HAGERSTOWN
State MD
ZIP 21740
Phone 301 393-3786
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 TE LIM

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