45D2126424 CLIA NUMBER - SAM'S CLUB PHARMACY CLUB 10-6381

Laboratory Demographics

  • CLIA Code: 45D2126424
  • Facility Name: SAM'S CLUB PHARMACY CLUB 10-6381
  • Facility Address: 751 W MAIN STREET
    LEWISVILLE, TX
    ZIP 75067
  • Facility Phone: 972 436-6684
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LEEJIA M. ABRAHAM
  • NPI Number: 1831288711
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2126424
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY CLUB 10-6381
Street 751 W MAIN STREET
City LEWISVILLE
State TX
ZIP 75067
Phone 972 436-6684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Pharmacy
Lab Director LEEJIA M. ABRAHAM

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