23D2011292 CLIA NUMBER - WALGREENS #07206

Laboratory Demographics

  • CLIA Code: 23D2011292
  • Facility Name: WALGREENS #07206
  • Facility Address: 5709 S TELEGRAPH RD
    DEARBORN HEIGHTS, MI
    ZIP 48125
  • Facility Phone: 313 292-1599
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOE T. BAZZY
  • NPI Number: 1093720393
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2011292
LAB Type Pharmacy
Facility Name WALGREENS #07206
Street 5709 S TELEGRAPH RD
City DEARBORN HEIGHTS
State MI
ZIP 48125
Phone 313 292-1599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Pharmacy
Lab Director MOE T. BAZZY

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