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

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Laboratory Demographics

CLIA Number: 23D2099768

Facility Name: SAM'S PHARMACY 10-4944

Facility Address:
6160 S SAGINAW ROAD
GRAND BLANC, MI
ZIP 48439
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Facility Phone Number: 810 603-9702

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1710904180

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	23D2099768
LAB Type	Pharmacy
Facility Name	SAM'S PHARMACY 10-4944
Street	6160 S SAGINAW ROAD
City	GRAND BLANC
State	MI
ZIP	48439
Phone	810 603-9702
CertificateType	4
CertificateEffectiveDate	8/3/2023
CertificateExpirationDate	8/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024