23D2099768 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4944

Laboratory Demographics

  • CLIA Code: 23D2099768
  • Facility Name: SAM'S CLUB PHARMACY 10-4944
  • Facility Address: 6160 S SAGINAW ROAD
    GRAND BLANC, MI
    ZIP 48439
  • Facility Phone: 810 603-9702
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MONICA AZIZ
  • NPI Number: 1710904180
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2099768
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4944
Street 6160 S SAGINAW ROAD
City GRAND BLANC
State MI
ZIP 48439
Phone 810 603-9702
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 MONICA AZIZ

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