44D2137733 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4930

Laboratory Demographics

  • CLIA Code: 44D2137733
  • Facility Name: SAM'S CLUB PHARMACY 10-4930
  • Facility Address: 1177 SAMS STREET
    COOKEVILLE, TN
    ZIP 38506
  • Facility Phone: 931 372-0300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL ANGEL
  • NPI Number: 1245624071
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 44D2137733
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4930
Street 1177 SAMS STREET
City COOKEVILLE
State TN
ZIP 38506
Phone 931 372-0300
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 RACHEL ANGEL

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