51D2129213 CLIA NUMBER - SAM'S EAST, INC D/B/A SAM'S PHARMACY #10-4860

Laboratory Demographics

  • CLIA Code: 51D2129213
  • Facility Name: SAM'S EAST, INC D/B/A SAM'S PHARMACY #10-4860
  • Facility Address: 1220 N EISENHOWER DR
    BECKLEY, WV
    ZIP 25801
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA VANHOOSE
  • NPI Number: 1720005861
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2129213
LAB Type Pharmacy
Facility Name SAM'S EAST, INC D/B/A SAM'S PHARMACY #10-4860
Street 1220 N EISENHOWER DR
City BECKLEY
State WV
ZIP 25801
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 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Pharmacy
Lab Director AMANDA VANHOOSE

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