36D2140045 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8136

Laboratory Demographics

  • CLIA Code: 36D2140045
  • Facility Name: SAM'S CLUB PHARMACY 10-8136
  • Facility Address: 1111 MIAMISBURG CENTERVILLE RD
    WASHINGTON TOWNSHIP, OH
    ZIP 45459
  • Facility Phone: 937 291-0197
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: COREY BRAND
  • NPI Number: 1538263967
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 36D2140045
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8136
Street 1111 MIAMISBURG CENTERVILLE RD
City WASHINGTON TOWNSHIP
State OH
ZIP 45459
Phone 937 291-0197
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Pharmacy
Lab Director COREY BRAND

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