One way to tell if a clam is healthy is when your looking at a clam at the fish store (assuming your talking about High Light clams) wave your hand over the tank creating a shadow. If the clam closes up quickly it is a sign its healthy.
the shadow test is good, but not the only thing to look at. make sure mantles r fully extended, and no bleached area to speak of. also, a gaping clam (the opening where it intakes water) is also a sign of bad health.