CLIA lab
CLIA 15D2136086: Sam's Club Pharmacy 10-6437
Bloomington, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D2136086 belongs to Sam's Club Pharmacy 10-6437 in Bloomington, IN.
Certificate of Waiver, effective September 1, 2025, expires August 31, 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
- September 1, 2025
- Certificate expiration
- August 31, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 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
- 15D2136086
- Lab name
- Sam's Club Pharmacy 10-6437
- Address
- 3205 West State Hwy 45, Bloomington, IN 47403
- Phone
- (812) 333-8903
- Fax
- (812) 333-8906
Annual test volume the lab reported
- Waived tests
- 5,000
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 Sam's Club Pharmacy 10-6437 in Bloomington?
15D2136086, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Sam's Club Pharmacy 10-6437 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 15D2136086 expire?
The CMS file lists August 31, 2027 as the certificate expiration date; the certificate took effect September 1, 2025.