27D2129902 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4805

Laboratory Demographics

  • CLIA Code: 27D2129902
  • Facility Name: SAM'S CLUB PHARMACY 10-4805
  • Facility Address: 4420 KING AVE E
    BILLINGS, MT
    ZIP 59101
  • Facility Phone: 406 256-0177
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRAIG E. BOMAN
  • NPI Number: 1881924413
  • Taxonomy: 156FX1800X - Technician/Technologist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 27D2129902
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4805
Street 4420 KING AVE E
City BILLINGS
State MT
ZIP 59101
Phone 406 256-0177
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director CRAIG E. BOMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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