51D2126364 CLIA NUMBER - SAM'S EAST, INC DBA SAM'S PHARMACY #10-4936

Laboratory Demographics

  • CLIA Code: 51D2126364
  • Facility Name: SAM'S EAST, INC DBA SAM'S PHARMACY #10-4936
  • Facility Address: 5045 UNIVERSITY TOWN CENTER DRIVE
    MORGANTOWN, WV
    ZIP 26501
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAIRA DALTON
  • NPI Number: 1720172877
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2126364
LAB Type Pharmacy
Facility Name SAM'S EAST, INC DBA SAM'S PHARMACY #10-4936
Street 5045 UNIVERSITY TOWN CENTER DRIVE
City MORGANTOWN
State WV
ZIP 26501
Phone 479 258-6734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2025
Certificate Expiration Date 2/23/2027
Facility Type Pharmacy
Lab Director KAIRA DALTON

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