23D2011302 CLIA NUMBER - WALGREENS #03364

Laboratory Demographics

  • CLIA Code: 23D2011302
  • Facility Name: WALGREENS #03364
  • Facility Address: 907 S 11TH ST
    NILES, MI
    ZIP 49120
  • Facility Phone: 269 683-0234
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAUL MORALES
  • NPI Number: 1437164548
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2011302
LAB Type Pharmacy
Facility Name WALGREENS #03364
Street 907 S 11TH ST
City NILES
State MI
ZIP 49120
Phone 269 683-0234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Pharmacy
Lab Director RAUL MORALES

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