CLIA lab

CLIA 23D2099776: Sam's Pharmacy 10-6412

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

CLIA number 23D2099776 belongs to Sam's Pharmacy 10-6412 in Southgate, MI.

Certificate of Waiver, effective August 3, 2025, expires August 2, 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
August 3, 2025
Certificate expiration
August 2, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
August 3, 2015
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
23D2099776
Lab name
Sam's Pharmacy 10-6412
Address
15700 Northline Road, Southgate, MI 48195
Phone
(734) 281-4863
Fax
(734) 281-4968

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 Pharmacy 10-6412 in Southgate?

23D2099776, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Sam's Pharmacy 10-6412 hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 23D2099776 expire?

The CMS file lists August 2, 2027 as the certificate expiration date; the certificate took effect August 3, 2025.

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