23D2011507 CLIA NUMBER - WALGREENS #04748

Laboratory Demographics

  • CLIA Code: 23D2011507
  • Facility Name: WALGREENS #04748
  • Facility Address: 30852 WOODWARD AVE
    ROYAL OAK, MI
    ZIP 48073
  • Facility Phone: 248 549-2628
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: RANI GORIYO
  • NPI Number: 1558376673
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2011507
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #04748
Street 30852 WOODWARD AVE
City ROYAL OAK
State MI
ZIP 48073
Phone 248 549-2628
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Other - COVID-19 TEST SITE
Lab Director RANI GORIYO

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