45D2127888 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8275

Laboratory Demographics

  • CLIA Code: 45D2127888
  • Facility Name: SAM'S CLUB PHARMACY 10-8275
  • Facility Address: 1615 INTERSTATE 10 SOUTH
    BEAUMONT, TX
    ZIP 77701
  • Facility Phone: 409 840-9776
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIFFANY GORE
  • NPI Number: 1902995228
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2127888
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8275
Street 1615 INTERSTATE 10 SOUTH
City BEAUMONT
State TX
ZIP 77701
Phone 409 840-9776
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Pharmacy
Lab Director TIFFANY GORE

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