45D2126491 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4783

Laboratory Demographics

  • CLIA Code: 45D2126491
  • Facility Name: SAM'S CLUB PHARMACY 10-4783
  • Facility Address: 5150 N GARLAND AVENUE
    GARLAND, TX
    ZIP 75040
  • Facility Phone: 972 530-8496
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATHLEEN DODDS
  • NPI Number: 1689768970
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2126491
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4783
Street 5150 N GARLAND AVENUE
City GARLAND
State TX
ZIP 75040
Phone 972 530-8496
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Pharmacy
Lab Director KATHLEEN DODDS

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