36D2133248 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8132

Laboratory Demographics

  • CLIA Code: 36D2133248
  • Facility Name: SAM'S CLUB PHARMACY 10-8132
  • Facility Address: 800 KEMPER COMMONS CIR
    SPRINGDALE, OH
    ZIP 45246
  • Facility Phone: 513 671-2090
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SCOTT MONTGOMERY
  • NPI Number: 1033212089
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 36D2133248
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8132
Street 800 KEMPER COMMONS CIR
City SPRINGDALE
State OH
ZIP 45246
Phone 513 671-2090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Pharmacy
Lab Director SCOTT MONTGOMERY

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