26D2126436 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S PHARMACY 10-6505

Laboratory Demographics

  • CLIA Code: 26D2126436
  • Facility Name: SAM'S EAST, INC DBA SAM'S PHARMACY 10-6505
  • Facility Address: 849 STONERIDGE PARKWAY
    JEFFERSON CITY, MO
    ZIP 65109
  • Facility Phone: 573 469-0906
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAM BRANUM
  • NPI Number: 1700265642
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 26D2126436
LAB Type Pharmacy
Facility Name SAM'S EAST, INC DBA SAM'S PHARMACY 10-6505
Street 849 STONERIDGE PARKWAY
City JEFFERSON CITY
State MO
ZIP 65109
Phone 573 469-0906
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Pharmacy
Lab Director SAM BRANUM

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