23D2099776 CLIA NUMBER - SAM'S PHARMACY 10-6412

Laboratory Demographics

  • CLIA Code: 23D2099776
  • Facility Name: SAM'S PHARMACY 10-6412
  • Facility Address: 15700 NORTHLINE ROAD
    SOUTHGATE, MI
    ZIP 48195
  • Facility Phone: 734 281-4863
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBORAH L. CHUHRAN CASH
  • NPI Number: 1821015041
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2099776
LAB Type Pharmacy
Facility Name SAM'S PHARMACY 10-6412
Street 15700 NORTHLINE ROAD
City SOUTHGATE
State MI
ZIP 48195
Phone 734 281-4863
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 DEBORAH L. CHUHRAN CASH

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