23D2099764 CLIA NUMBER - SAM'S PHARMACY 10-6319

Laboratory Demographics

  • CLIA Code: 23D2099764
  • Facility Name: SAM'S PHARMACY 10-6319
  • Facility Address: 4326 28TH STREET SE
    KENTWOOD, MI
    ZIP 49512
  • Facility Phone: 616 285-3346
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW D. GILBERT
  • NPI Number: 1093732216
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2099764
LAB Type Pharmacy
Facility Name SAM'S PHARMACY 10-6319
Street 4326 28TH STREET SE
City KENTWOOD
State MI
ZIP 49512
Phone 616 285-3346
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2025
Certificate Expiration Date 8/2/2027
Facility Type Pharmacy
Lab Director MATTHEW D. GILBERT

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