45D2127635 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4702

Laboratory Demographics

  • CLIA Code: 45D2127635
  • Facility Name: SAM'S CLUB PHARMACY 10-4702
  • Facility Address: 155 W EL DORADO BLVD
    FRIENDSWOOD, TX
    ZIP 77546
  • Facility Phone: 281 286-4471
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LEZLEY PACHECO
  • NPI Number: 1205921129
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2127635
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4702
Street 155 W EL DORADO BLVD
City FRIENDSWOOD
State TX
ZIP 77546
Phone 281 286-4471
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Pharmacy
Lab Director LEZLEY PACHECO

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