28D2133383 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8146

Laboratory Demographics

  • CLIA Code: 28D2133383
  • Facility Name: SAM'S CLUB PHARMACY 10-8146
  • Facility Address: 13130 L STREET
    OMAHA, NE
    ZIP 68137
  • Facility Phone: 402 334-3497
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMBER K. SUDETA
  • NPI Number: 1427134105
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 28D2133383
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8146
Street 13130 L STREET
City OMAHA
State NE
ZIP 68137
Phone 402 334-3497
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Pharmacy
Lab Director AMBER K. SUDETA

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