23D1004098 CLIA NUMBER - MEIJER PHARMACY #123

Laboratory Demographics

  • CLIA Code: 23D1004098
  • Facility Name: MEIJER PHARMACY #123
  • Facility Address: 16300 FORT STREET
    SOUTHGATE, MI
    ZIP 48195
  • Facility Phone: 734 284-4250
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1477002970
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D1004098
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #123
Street 16300 FORT STREET
City SOUTHGATE
State MI
ZIP 48195
Phone 734 284-4250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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This page was last updated on: 9/29/2025