23D2011301 CLIA NUMBER - WALGREENS #04255

Laboratory Demographics

  • CLIA Code: 23D2011301
  • Facility Name: WALGREENS #04255
  • Facility Address: 31100 GROESBECK HWY
    FRASER, MI
    ZIP 48026
  • Facility Phone: 586 294-5729
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY L. DINTY
  • NPI Number: 1740297738
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2011301
LAB Type Pharmacy
Facility Name WALGREENS #04255
Street 31100 GROESBECK HWY
City FRASER
State MI
ZIP 48026
Phone 586 294-5729
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Pharmacy
Lab Director KIMBERLY L. DINTY

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This page was last updated on: 3/20/2025