23D2099777 CLIA NUMBER - SAM'S PHARMACY 10-6454

Laboratory Demographics

  • CLIA Code: 23D2099777
  • Facility Name: SAM'S PHARMACY 10-6454
  • Facility Address: 22500 W 8 MILE ROAD
    SOUTHFIELD, MI
    ZIP 48033
  • Facility Phone: 248 357-2158
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FADI SALEM
  • NPI Number: 1720005192
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2099777
LAB Type Pharmacy
Facility Name SAM'S PHARMACY 10-6454
Street 22500 W 8 MILE ROAD
City SOUTHFIELD
State MI
ZIP 48033
Phone 248 357-2158
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