37D2126580 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8239 SAM'S WEST, INC

Laboratory Demographics

  • CLIA Code: 37D2126580
  • Facility Name: SAM'S CLUB PHARMACY 10-8239 SAM'S WEST, INC
  • Facility Address: 802 N SHERIDAN ROAD
    LAWTON, OK
    ZIP 73505
  • Facility Phone: 508 713-7160
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRYSTAL WEATHERLY
  • NPI Number: 1982030904
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2126580
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8239 SAM'S WEST, INC
Street 802 N SHERIDAN ROAD
City LAWTON
State OK
ZIP 73505
Phone 508 713-7160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Pharmacy
Lab Director CRYSTAL WEATHERLY

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