36D2133273 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6517

Laboratory Demographics

  • CLIA Code: 36D2133273
  • Facility Name: SAM'S CLUB PHARMACY 10-6517
  • Facility Address: 3446 PENTAGON BLVD
    BEAVERCREEK, OH
    ZIP 45431
  • Facility Phone: (937) 427-0879
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDSEY M. STEFAN

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CLIA Record

Field Name Field Value
CLIA Number 36D2133273
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6517
Street 3446 PENTAGON BLVD
City BEAVERCREEK
State OH
ZIP 45431
Phone 9374270879
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 LINDSEY M. STEFAN

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This page was last updated on: 5/18/2026