45D2136919 CLIA NUMBER - SAM'S CLUB PAHRMACY 10-6246

Laboratory Demographics

  • CLIA Code: 45D2136919
  • Facility Name: SAM'S CLUB PAHRMACY 10-6246
  • Facility Address: 9498 GATEWAY NORTH
    EL PASO, TX
    ZIP 79924
  • Facility Phone: 915 730-6092
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TABITHA A. CABRERA
  • NPI Number: 1962807669
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2136919
LAB Type Pharmacy
Facility Name SAM'S CLUB PAHRMACY 10-6246
Street 9498 GATEWAY NORTH
City EL PASO
State TX
ZIP 79924
Phone 915 730-6092
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Pharmacy
Lab Director TABITHA A. CABRERA

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