45D2134890 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8250

Laboratory Demographics

  • CLIA Code: 45D2134890
  • Facility Name: SAM'S CLUB PHARMACY 10-8250
  • Facility Address: 1400 E JACKSON AVENUE
    MCALLEN, TX
    ZIP 78503
  • Facility Phone: 956 683-8895
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THUTHAO T. PHAN
  • NPI Number: 1447333703
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2134890
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8250
Street 1400 E JACKSON AVENUE
City MCALLEN
State TX
ZIP 78503
Phone 956 683-8895
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director THUTHAO T. PHAN

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