36D2133283 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6380

Laboratory Demographics

  • CLIA Code: 36D2133283
  • Facility Name: SAM'S CLUB PHARMACY 10-6380
  • Facility Address: 6955 MILLER LN
    DAYTON, OH
    ZIP 45414
  • Facility Phone: 937 415-0198
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. KIMMY MAI
  • NPI Number: 1285739888
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2133283
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6380
Street 6955 MILLER LN
City DAYTON
State OH
ZIP 45414
Phone 937 415-0198
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 MS. KIMMY MAI

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