26D2126147 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S PHARMACY 10-8296

Laboratory Demographics

  • CLIA Code: 26D2126147
  • Facility Name: SAM'S EAST, INC DBA SAM'S PHARMACY 10-8296
  • Facility Address: 3660 E SUNSHINE ST
    SPRINGFIELD, MO
    ZIP 65809
  • Facility Phone: 417 882-8245
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JILYAN RUCKMAN
  • NPI Number: 1851318117
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2126147
LAB Type Pharmacy
Facility Name SAM'S EAST, INC DBA SAM'S PHARMACY 10-8296
Street 3660 E SUNSHINE ST
City SPRINGFIELD
State MO
ZIP 65809
Phone 417 882-8245
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Pharmacy
Lab Director JILYAN RUCKMAN

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