23D2099765 CLIA NUMBER - SAM'S PHARMACY 10-6659

Laboratory Demographics

  • CLIA Code: 23D2099765
  • Facility Name: SAM'S PHARMACY 10-6659
  • Facility Address: 31020 JOHN R ROAD
    MADISON HEIGHTS, MI
    ZIP 48071
  • Facility Phone: 248 589-1863
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NABEEL AZZAM
  • NPI Number: 1275550642
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2099765
LAB Type Pharmacy
Facility Name SAM'S PHARMACY 10-6659
Street 31020 JOHN R ROAD
City MADISON HEIGHTS
State MI
ZIP 48071
Phone 248 589-1863
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 NABEEL AZZAM

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