23D2011492 CLIA NUMBER - WALGREENS #03349

Laboratory Demographics

  • CLIA Code: 23D2011492
  • Facility Name: WALGREENS #03349
  • Facility Address: 510 N BEACON BLVD
    GRAND HAVEN, MI
    ZIP 49417
  • Facility Phone: 616 850-9613
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER R. MOBLO
  • NPI Number: 1194046722
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2011492
LAB Type Pharmacy
Facility Name WALGREENS #03349
Street 510 N BEACON BLVD
City GRAND HAVEN
State MI
ZIP 49417
Phone 616 850-9613
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2025
Certificate Expiration Date 8/8/2027
Facility Type Pharmacy
Lab Director CHRISTOPHER R. MOBLO

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