26D2126144 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S PHARMACY 10-8205

Laboratory Demographics

CLIA Number: 26D2126144

Facility Name: SAM'S EAST, INC DBA SAM'S PHARMACY 10-8205

Facility Address:
4512 LEMAY FERRY RD
SAINT LOUIS, MO
ZIP 63129
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Facility Phone Number: 314 894-6893

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316964653

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	26D2126144
LAB Type	Physician Office
Facility Name	SAM'S EAST, INC DBA SAM'S PHARMACY 10-8205
Street	4512 LEMAY FERRY RD
City	SAINT LOUIS
State	MO
ZIP	63129
Phone	314 894-6893
CertificateType	4
CertificateEffectiveDate	2/21/2023
CertificateExpirationDate	2/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024