23D1008374 CLIA NUMBER - MEIJER PHARMACY #163

Laboratory Demographics

  • CLIA Code: 23D1008374
  • Facility Name: MEIJER PHARMACY #163
  • Facility Address: 4775 24TH AVE
    FORT GRATIOT, MI
    ZIP 48059
  • Facility Phone: 810 385-2110
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1831248459
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D1008374
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #163
Street 4775 24TH AVE
City FORT GRATIOT
State MI
ZIP 48059
Phone 810 385-2110
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: 9/29/2025