45D2140952 CLIA NUMBER - SAM'S CLUB PHARMACY 10-8286

Laboratory Demographics

  • CLIA Code: 45D2140952
  • Facility Name: SAM'S CLUB PHARMACY 10-8286
  • Facility Address: 2301 E WACO DR
    WACO, TX
    ZIP 76705
  • Facility Phone: 254 799-2408
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WERNER J. FOURIE
  • NPI Number: 1710076047
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2140952
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-8286
Street 2301 E WACO DR
City WACO
State TX
ZIP 76705
Phone 254 799-2408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Pharmacy
Lab Director WERNER J. FOURIE

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