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

Laboratory Demographics

CLIA Number: 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
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Facility Phone Number: 479 258-6734

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1720005861

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

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
CertificateType 4
CertificateEffectiveDate 4/17/2023
CertificateExpirationDate 4/16/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024