23D1008353 CLIA NUMBER - MEIJER PHARMACY #196

Laboratory Demographics

  • CLIA Code: 23D1008353
  • Facility Name: MEIJER PHARMACY #196
  • Facility Address: 8850 SHAVER ROAD
    PORTAGE, MI
    ZIP 49024
  • Facility Phone: (269) 321-4310
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1801942560
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D1008353
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #196
Street 8850 SHAVER ROAD
City PORTAGE
State MI
ZIP 49024
Phone 2693214310
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2025
Certificate Expiration Date 1/20/2027
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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This page was last updated on: 5/18/2026