46D2133192 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6684

Laboratory Demographics

  • CLIA Code: 46D2133192
  • Facility Name: SAM'S CLUB PHARMACY 10-6684
  • Facility Address: 4949 S 900 W
    RIVERDALE, UT
    ZIP 84405
  • Facility Phone: 801 612-3477
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ZACHARY D. UELAND
  • NPI Number: 1245329226
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 46D2133192
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6684
Street 4949 S 900 W
City RIVERDALE
State UT
ZIP 84405
Phone 801 612-3477
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 ZACHARY D. UELAND

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