23D2099788 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4778

Laboratory Demographics

  • CLIA Code: 23D2099788
  • Facility Name: SAM'S CLUB PHARMACY 10-4778
  • Facility Address: 4350 JOSLYN ROAD
    AUBURN HILLS, MI
    ZIP 48326
  • Facility Phone: 248 391-6697
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LYUBOV LANE
  • NPI Number: 1548287766
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2099788
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4778
Street 4350 JOSLYN ROAD
City AUBURN HILLS
State MI
ZIP 48326
Phone 248 391-6697
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 LYUBOV LANE

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