36D2133268 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4962

Laboratory Demographics

  • CLIA Code: 36D2133268
  • Facility Name: SAM'S CLUB PHARMACY 10-4962
  • Facility Address: 614 CROSSINGS RD
    SANDUSKY, OH
    ZIP 44870
  • Facility Phone: 419 626-1820
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRAIG M. NUTTER
  • NPI Number: 1083707848
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2133268
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4962
Street 614 CROSSINGS RD
City SANDUSKY
State OH
ZIP 44870
Phone 419 626-1820
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 CRAIG M. NUTTER

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