26D2126040 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S PHARMACY 10-8293

Laboratory Demographics

  • CLIA Code: 26D2126040
  • Facility Name: SAM'S EAST, INC DBA SAM'S PHARMACY 10-8293
  • Facility Address: 4100 S BOLGER RD
    INDEPENDENCE, MO
    ZIP 64055
  • Facility Phone: 816 350-2931
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LADONNA STEPHENS
  • NPI Number: 1780601013
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2126040
LAB Type Pharmacy
Facility Name SAM'S EAST, INC DBA SAM'S PHARMACY 10-8293
Street 4100 S BOLGER RD
City INDEPENDENCE
State MO
ZIP 64055
Phone 816 350-2931
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Pharmacy
Lab Director LADONNA STEPHENS

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