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26D2126155 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S PHARMACY 10-6479

Laboratory Demographics

CLIA Number: 26D2126155

Facility Name: SAM'S EAST, INC DBA SAM'S PHARMACY 10-6479

Facility Address:
232 SHIRLEY DRIVE
CAPE GIRARDEAU, MO
ZIP 63701
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Facility Phone Number: 573 332-0329

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1780974832

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 26D2126155
LAB Type Pharmacy
Facility Name SAM'S EAST, INC DBA SAM'S PHARMACY 10-6479
Street 232 SHIRLEY DRIVE
City CAPE GIRARDEAU
State MO
ZIP 63701
Phone 573 332-0329
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