45D2134798 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8227

Laboratory Demographics

  • CLIA Code: 45D2134798
  • Facility Name: SAM'S CLUB PHARMACY 10-8227
  • Facility Address: 5055 NW LOOP 410
    SAN ANTONIO, TX
    ZIP 78229
  • Facility Phone: 210 682-7144
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT A. MOTON
  • NPI Number: 1871674549
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2134798
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8227
Street 5055 NW LOOP 410
City SAN ANTONIO
State TX
ZIP 78229
Phone 210 682-7144
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2025
Certificate Expiration Date 8/8/2027
Facility Type Pharmacy
Lab Director ROBERT A. MOTON

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