34D2130347 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6216

Laboratory Demographics

  • CLIA Code: 34D2130347
  • Facility Name: SAM'S CLUB PHARMACY 10-6216
  • Facility Address: 4240 WINTERVILLE PARKWAY
    WINTERVILLE, NC
    ZIP 28590
  • Facility Phone: 252 756-2788
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHAWN R. VERES
  • NPI Number: 1174722797
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2130347
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6216
Street 4240 WINTERVILLE PARKWAY
City WINTERVILLE
State NC
ZIP 28590
Phone 252 756-2788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2025
Certificate Expiration Date 5/7/2027
Facility Type Pharmacy
Lab Director SHAWN R. VERES

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