52D2258434 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6324

Laboratory Demographics

  • CLIA Code: 52D2258434
  • Facility Name: SAM'S CLUB PHARMACY 10-6324
  • Facility Address: 8050 N 124TH ST
    MILWAUKEE, WI
    ZIP 53223
  • Facility Phone: 618 622-0507
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EVA MILA OCULARES
  • NPI Number: 1790880920
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 52D2258434
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6324
Street 8050 N 124TH ST
City MILWAUKEE
State WI
ZIP 53223
Phone 618 622-0507
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2024
Certificate Expiration Date 4/20/2026
Facility Type Pharmacy
Lab Director EVA MILA OCULARES

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