23D1089746 CLIA NUMBER - WALGREENS #11264

Laboratory Demographics

  • CLIA Code: 23D1089746
  • Facility Name: WALGREENS #11264
  • Facility Address: 21790 21 MILE ROAD
    MACOMB, MI
    ZIP 48044
  • Facility Phone: 586 469-0254
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD RAMZAN
  • NPI Number: 1720263122
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D1089746
LAB Type Pharmacy
Facility Name WALGREENS #11264
Street 21790 21 MILE ROAD
City MACOMB
State MI
ZIP 48044
Phone 586 469-0254
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director MOHAMMAD RAMZAN

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