45D2128825 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6453

Laboratory Demographics

  • CLIA Code: 45D2128825
  • Facility Name: SAM'S CLUB PHARMACY 10-6453
  • Facility Address: 9700 N CAPITOL OF TX HWY
    AUSTIN, TX
    ZIP 78759
  • Facility Phone: 512 343-8262
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN HOFER
  • NPI Number: 1730279985
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2128825
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6453
Street 9700 N CAPITOL OF TX HWY
City AUSTIN
State TX
ZIP 78759
Phone 512 343-8262
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Pharmacy
Lab Director LAUREN HOFER

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