32D2139065 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6347

Laboratory Demographics

  • CLIA Code: 32D2139065
  • Facility Name: SAM'S CLUB PHARMACY 10-6347
  • Facility Address: 4500 E MAIN ST
    FARMINGTON, NM
    ZIP 87402
  • Facility Phone: 505 326-5384
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARY C. HAYASHI
  • NPI Number: 1992899033
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 32D2139065
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6347
Street 4500 E MAIN ST
City FARMINGTON
State NM
ZIP 87402
Phone 505 326-5384
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Pharmacy
Lab Director MARY C. HAYASHI

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