49D2131664 CLIA NUMBER - SAM'S EAST, LP D/B/A SAM'S PHARMACY #10-4996

Laboratory Demographics

  • CLIA Code: 49D2131664
  • Facility Name: SAM'S EAST, LP D/B/A SAM'S PHARMACY #10-4996
  • Facility Address: 215 PIEDMONT PLACE
    DANVILLE, VA
    ZIP 24541
  • Facility Phone: 434 797-3439
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILEY JACKSON
  • NPI Number: 1558630756
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 49D2131664
LAB Type Pharmacy
Facility Name SAM'S EAST, LP D/B/A SAM'S PHARMACY #10-4996
Street 215 PIEDMONT PLACE
City DANVILLE
State VA
ZIP 24541
Phone 434 797-3439
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type Pharmacy
Lab Director WILEY JACKSON

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