CLIA lab
CLIA 45D2125484: Sam's Club Pharmacy 10-4795
Grapevine, TX. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 45D2125484 belongs to Sam's Club Pharmacy 10-4795 in Grapevine, TX.
Certificate of Waiver, effective June 10, 2026, expires June 9, 2028.
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
- June 10, 2026
- Certificate expiration
- June 9, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 8, 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
- 45D2125484
- Lab name
- Sam's Club Pharmacy 10-4795
- Address
- 1701 W State Highway 114, Grapevine, TX 76051
- Phone
- (682) 271-5221
- Fax
- (682) 271-5223
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 10-4795 in Grapevine?
45D2125484, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Sam's Club Pharmacy 10-4795 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 45D2125484 expire?
The CMS file lists June 9, 2028 as the certificate expiration date; the certificate took effect June 10, 2026.