45D2125368 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6255

Laboratory Demographics

  • CLIA Code: 45D2125368
  • Facility Name: SAM'S CLUB PHARMACY 10-6255
  • Facility Address: 8621 OHIO DRIVE
    PLANO, TX
    ZIP 75024
  • Facility Phone: 469 633-0026
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KETAN C. NAIK
  • NPI Number: 1396838223
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2125368
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6255
Street 8621 OHIO DRIVE
City PLANO
State TX
ZIP 75024
Phone 469 633-0026
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Pharmacy
Lab Director KETAN C. NAIK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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