45D2126271 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4939

Laboratory Demographics

  • CLIA Code: 45D2126271
  • Facility Name: SAM'S CLUB PHARMACY 10-4939
  • Facility Address: 3239 GOLIAD ROAD
    SAN ANTONIO, TX
    ZIP 78223
  • Facility Phone: 210 507-0492
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MONICA L. MARTINEZ
  • NPI Number: 1649691478
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2126271
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4939
Street 3239 GOLIAD ROAD
City SAN ANTONIO
State TX
ZIP 78223
Phone 210 507-0492
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Pharmacy
Lab Director MONICA L. MARTINEZ

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