28D2134638 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4873

Laboratory Demographics

  • CLIA Code: 28D2134638
  • Facility Name: SAM'S CLUB PHARMACY 10-4873
  • Facility Address: 8480 ANDERMATT DR
    LINCOLN, NE
    ZIP 68526
  • Facility Phone: 402 975-6908
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TITCHENER R. MATTHEW
  • NPI Number: 1578827614
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 28D2134638
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4873
Street 8480 ANDERMATT DR
City LINCOLN
State NE
ZIP 68526
Phone 402 975-6908
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Pharmacy
Lab Director TITCHENER R. MATTHEW

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