49D2131858 CLIA NUMBER - SAM'S EAST LP D/B/A SAM'S PHARMACY # 10-8220

Laboratory Demographics

  • CLIA Code: 49D2131858
  • Facility Name: SAM'S EAST LP D/B/A SAM'S PHARMACY # 10-8220
  • Facility Address: 1455 TOWN SQUARE BOULEVARD
    ROANOKE, VA
    ZIP 24012
  • Facility Phone: 540 527-2362
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK C. DORSEY
  • NPI Number: 1265459374
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2131858
LAB Type Pharmacy
Facility Name SAM'S EAST LP D/B/A SAM'S PHARMACY # 10-8220
Street 1455 TOWN SQUARE BOULEVARD
City ROANOKE
State VA
ZIP 24012
Phone 540 527-2362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Pharmacy
Lab Director MARK C. DORSEY

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