52D2261832 CLIA NUMBER - SAM'S CLUB PHARMACY 10-6321

Laboratory Demographics

  • CLIA Code: 52D2261832
  • Facility Name: SAM'S CLUB PHARMACY 10-6321
  • Facility Address: 1000 N WESTHILL BLVD
    APPLETON, WI
    ZIP 54914
  • Facility Phone: 903 597-1863
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANNETTE SCHRANK
  • NPI Number: 1821185711
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 52D2261832
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY 10-6321
Street 1000 N WESTHILL BLVD
City APPLETON
State WI
ZIP 54914
Phone 903 597-1863
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Pharmacy
Lab Director ANNETTE SCHRANK

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