36D2133271 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6404

Laboratory Demographics

  • CLIA Code: 36D2133271
  • Facility Name: SAM'S CLUB PHARMACY 10-6404
  • Facility Address: 3750 W MARKET ST, UNIT J
    FAIRLAWN, OH
    ZIP 44333
  • Facility Phone: (330) 668-1176
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TINA M. BOLHA

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CLIA Record

Field Name Field Value
CLIA Number 36D2133271
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6404
Street 3750 W MARKET ST, UNIT J
City FAIRLAWN
State OH
ZIP 44333
Phone 3306681176
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 TINA M. BOLHA

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This page was last updated on: 5/15/2026