23D2011305 CLIA NUMBER - WALGREENS #10078

Laboratory Demographics

  • CLIA Code: 23D2011305
  • Facility Name: WALGREENS #10078
  • Facility Address: 875 E NAPIER AVE
    BENTON HARBOR, MI
    ZIP 49022
  • Facility Phone: 269 983-3463
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYESHA A. LIPSCOMB
  • NPI Number: 1275548380
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2011305
LAB Type Pharmacy
Facility Name WALGREENS #10078
Street 875 E NAPIER AVE
City BENTON HARBOR
State MI
ZIP 49022
Phone 269 983-3463
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Pharmacy
Lab Director KYESHA A. LIPSCOMB

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