34D2115502 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S CLUB PHARMACY 10-6976

Laboratory Demographics

  • CLIA Code: 34D2115502
  • Facility Name: SAM'S EAST, INC DBA SAM'S CLUB PHARMACY 10-6976
  • Facility Address: 11460 ROYALL COTTON ROAD
    WAKE FOREST, NC
    ZIP 27587
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEE M. CHITLA
  • NPI Number: 1336590611
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 34D2115502
LAB Type Pharmacy
Facility Name SAM'S EAST, INC DBA SAM'S CLUB PHARMACY 10-6976
Street 11460 ROYALL COTTON ROAD
City WAKE FOREST
State NC
ZIP 27587
Phone 479 258-6734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2024
Certificate Expiration Date 7/7/2026
Facility Type Pharmacy
Lab Director DEE M. CHITLA

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