44D2137718 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6507

Laboratory Demographics

  • CLIA Code: 44D2137718
  • Facility Name: SAM'S CLUB PHARMACY 10-6507
  • Facility Address: 2120 EMPORIUM DRIVE
    JACKSON, TN
    ZIP 38305
  • Facility Phone: 731 664-0113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHUA WHITE
  • NPI Number: 1902996960
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 44D2137718
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6507
Street 2120 EMPORIUM DRIVE
City JACKSON
State TN
ZIP 38305
Phone 731 664-0113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Pharmacy
Lab Director JOSHUA WHITE

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