51D2127079 CLIA NUMBER - SAM'S EAST, INC D/B/A SAM'S PHARMACY #10-8189

Laboratory Demographics

  • CLIA Code: 51D2127079
  • Facility Name: SAM'S EAST, INC D/B/A SAM'S PHARMACY #10-8189
  • Facility Address: 200 EMILY DRIVE
    CLARKSBURG, WV
    ZIP 26301
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAMERON SHROUT
  • NPI Number: 1902299746
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 51D2127079
LAB Type Pharmacy
Facility Name SAM'S EAST, INC D/B/A SAM'S PHARMACY #10-8189
Street 200 EMILY DRIVE
City CLARKSBURG
State WV
ZIP 26301
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 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Pharmacy
Lab Director CAMERON SHROUT

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