49D2131874 CLIA NUMBER - SAM'S EAST, LP D/B/A SAM'S PHARMACY # 10-6371

Laboratory Demographics

  • CLIA Code: 49D2131874
  • Facility Name: SAM'S EAST, LP D/B/A SAM'S PHARMACY # 10-6371
  • Facility Address: 14050 WORTH AVENUE
    WOODBRIDGE, VA
    ZIP 22192
  • Facility Phone: 703 492-2906
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADWOA Y. EDUSEI
  • NPI Number: 1720005838
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2131874
LAB Type Pharmacy
Facility Name SAM'S EAST, LP D/B/A SAM'S PHARMACY # 10-6371
Street 14050 WORTH AVENUE
City WOODBRIDGE
State VA
ZIP 22192
Phone 703 492-2906
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 ADWOA Y. EDUSEI

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