CLIA lab

CLIA 10D2124225: Costco Pharmacy #1249

Lutz, FL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 10D2124225 belongs to Costco Pharmacy #1249 in Lutz, FL.

Certificate of Waiver, effective January 11, 2025, expires January 10, 2027.

Active in the CMS Provider of Services file posted October 16, 2026.

Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page

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Certificate

Certificate type
Certificate of Waiver
Certificate effective
January 11, 2025
Certificate expiration
January 10, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
January 11, 2017
Facility type
Pharmacy
Ownership (control type)
Proprietary
Lab classification
CLIA laboratory

Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page

Lab and contact

CLIA number
10D2124225
Lab name
Costco Pharmacy #1249
Address
2225 Grand Cypress Drive, Lutz, FL 33559
Phone
(425) 313-8100
Fax
(425) 313-6922

Annual test volume the lab reported

Waived tests
200

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

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Related

Questions

What is the CLIA number for Costco Pharmacy #1249 in Lutz?

10D2124225, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Costco Pharmacy #1249 hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 10D2124225 expire?

The CMS file lists January 10, 2027 as the certificate expiration date; the certificate took effect January 11, 2025.

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