36D2133279 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4750

Laboratory Demographics

  • CLIA Code: 36D2133279
  • Facility Name: SAM'S CLUB PHARMACY 10-4750
  • Facility Address: 1189 BUCHHOLZER BLVD
    CUYAHOGA FALLS, OH
    ZIP 44221
  • Facility Phone: 330 929-4092
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FADY F. ABDLRASUL
  • NPI Number: 1033214143
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 36D2133279
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4750
Street 1189 BUCHHOLZER BLVD
City CUYAHOGA FALLS
State OH
ZIP 44221
Phone 330 929-4092
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 FADY F. ABDLRASUL

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