34D2127073 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S PHARMACY 10-6573

Laboratory Demographics

  • CLIA Code: 34D2127073
  • Facility Name: SAM'S EAST, INC DBA SAM'S PHARMACY 10-6573
  • Facility Address: 1170 WESTERN BOULEVARD
    JACKSONVILLE, NC
    ZIP 28546
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANTHONY RIGAURD
  • NPI Number: 1376866343
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2127073
LAB Type Pharmacy
Facility Name SAM'S EAST, INC DBA SAM'S PHARMACY 10-6573
Street 1170 WESTERN BOULEVARD
City JACKSONVILLE
State NC
ZIP 28546
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 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Pharmacy
Lab Director ANTHONY RIGAURD

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