36D2139034 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4947

Laboratory Demographics

  • CLIA Code: 36D2139034
  • Facility Name: SAM'S CLUB PHARMACY 10-4947
  • Facility Address: 3724 NORTHPOINTE DRIVE
    ZANESVILLE, OH
    ZIP 43701
  • Facility Phone: 740 452-6869
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DERRICK S. ROBRECHT
  • NPI Number: 1205920006
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 36D2139034
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4947
Street 3724 NORTHPOINTE DRIVE
City ZANESVILLE
State OH
ZIP 43701
Phone 740 452-6869
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Pharmacy
Lab Director DERRICK S. ROBRECHT

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