23D2099783 CLIA NUMBER - SAM'S CLUB 6660

Laboratory Demographics

  • CLIA Code: 23D2099783
  • Facility Name: SAM'S CLUB 6660
  • Facility Address: 1237 32ND STREET
    PORT HURON, MI
    ZIP 48060
  • Facility Phone: 810 982-5791
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLOTTE A. JAWORSKI
  • NPI Number: 1285651406
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2099783
LAB Type Pharmacy
Facility Name SAM'S CLUB 6660
Street 1237 32ND STREET
City PORT HURON
State MI
ZIP 48060
Phone 810 982-5791
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 CHARLOTTE A. JAWORSKI

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