44D2133368 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8112

Laboratory Demographics

  • CLIA Code: 44D2133368
  • Facility Name: SAM'S CLUB PHARMACY 10-8112
  • Facility Address: 6101 LEE HWY
    CHATTANOOGA, TN
    ZIP 37421
  • Facility Phone: 423 954-1274
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BJ GOUDRIDGE
  • NPI Number: 1356446124
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 44D2133368
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8112
Street 6101 LEE HWY
City CHATTANOOGA
State TN
ZIP 37421
Phone 423 954-1274
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Pharmacy
Lab Director BJ GOUDRIDGE

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