46D2133188 CLIA NUMBER - SAM'S CLUB PHARMACY 10-4730

Laboratory Demographics

  • CLIA Code: 46D2133188
  • Facility Name: SAM'S CLUB PHARMACY 10-4730
  • Facility Address: 7571 S 3800 W
    WEST JORDAN, UT
    ZIP 84084
  • Facility Phone: 801 282-5678
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN FARMER
  • NPI Number: 1285726794
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 46D2133188
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-4730
Street 7571 S 3800 W
City WEST JORDAN
State UT
ZIP 84084
Phone 801 282-5678
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2025
Certificate Expiration Date 7/6/2027
Facility Type Pharmacy
Lab Director RYAN FARMER

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