25D2125985 CLIA NUMBER - SAM'S PHARMACY 10-8271

Laboratory Demographics

  • CLIA Code: 25D2125985
  • Facility Name: SAM'S PHARMACY 10-8271
  • Facility Address: 257 GRANDVIEW BLVD
    MADISON, MS
    ZIP 39110
  • Facility Phone: 601 977-0948
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BILLY KING
  • NPI Number: 1437176856
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2125985
LAB Type Pharmacy
Facility Name SAM'S PHARMACY 10-8271
Street 257 GRANDVIEW BLVD
City MADISON
State MS
ZIP 39110
Phone 601 977-0948
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/16/2025
Certificate Expiration Date 2/15/2027
Facility Type Pharmacy
Lab Director BILLY KING

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