25D2127126 CLIA NUMBER - SAM'S PHARMACY 10-8236

Laboratory Demographics

  • CLIA Code: 25D2127126
  • Facility Name: SAM'S PHARMACY 10-8236
  • Facility Address: 10431 OLD HWY 49
    GULFPORT, MS
    ZIP 39503
  • Facility Phone: 228 832-4848
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LORY NGUYEN
  • NPI Number: 1609893023
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2127126
LAB Type Pharmacy
Facility Name SAM'S PHARMACY 10-8236
Street 10431 OLD HWY 49
City GULFPORT
State MS
ZIP 39503
Phone 228 832-4848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Pharmacy
Lab Director LORY NGUYEN

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