44D2140688 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6512

Laboratory Demographics

  • CLIA Code: 44D2140688
  • Facility Name: SAM'S CLUB PHARMACY 10-6512
  • Facility Address: 3315 GUTHRIE HWY
    CLARKSVILLE, TN
    ZIP 37040
  • Facility Phone: 931 552-4602
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WENDY BROCKMAN
  • NPI Number: 1083795678
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 44D2140688
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6512
Street 3315 GUTHRIE HWY
City CLARKSVILLE
State TN
ZIP 37040
Phone 931 552-4602
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Pharmacy
Lab Director WENDY BROCKMAN

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