23D2099773 CLIA NUMBER - SAM'S PHARMACY 10-6662

Laboratory Demographics

  • CLIA Code: 23D2099773
  • Facility Name: SAM'S PHARMACY 10-6662
  • Facility Address: 31720 GRATIOT AVENUE
    ROSEVILLE, MI
    ZIP 48066
  • Facility Phone: 586 415-9980
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FADI SALEM
  • NPI Number: 1538186754
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2099773
LAB Type Pharmacy
Facility Name SAM'S PHARMACY 10-6662
Street 31720 GRATIOT AVENUE
City ROSEVILLE
State MI
ZIP 48066
Phone 586 415-9980
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 FADI SALEM

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