25D2125574 CLIA NUMBER - SAM'S PHARMACY 10-6329

Laboratory Demographics

  • CLIA Code: 25D2125574
  • Facility Name: SAM'S PHARMACY 10-6329
  • Facility Address: 3833 N GLOSTER ST
    TUPELO, MS
    ZIP 38804
  • Facility Phone: 662 840-7601
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN RHODES
  • NPI Number: 1518984939
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2125574
LAB Type Pharmacy
Facility Name SAM'S PHARMACY 10-6329
Street 3833 N GLOSTER ST
City TUPELO
State MS
ZIP 38804
Phone 662 840-7601
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Pharmacy
Lab Director BRIAN RHODES

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