45D2142793 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6439

Laboratory Demographics

  • CLIA Code: 45D2142793
  • Facility Name: SAM'S CLUB PHARMACY 10-6439
  • Facility Address: 4230 JHON BEN SHEPPERS PKWY
    ODESSA, TX
    ZIP 79762
  • Facility Phone: 432 362-0634
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIPAK PATEL
  • NPI Number: 1952676819
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2142793
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6439
Street 4230 JHON BEN SHEPPERS PKWY
City ODESSA
State TX
ZIP 79762
Phone 432 362-0634
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Pharmacy
Lab Director DIPAK PATEL

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