23D2012843 CLIA NUMBER - WALGREENS #04991

Laboratory Demographics

  • CLIA Code: 23D2012843
  • Facility Name: WALGREENS #04991
  • Facility Address: 3016 S WESTNEDGE AVE
    KALAMAZOO, MI
    ZIP 49008
  • Facility Phone: 269 552-1518
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CALEB H. VANDYKE
  • NPI Number: 1366457483
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2012843
LAB Type Pharmacy
Facility Name WALGREENS #04991
Street 3016 S WESTNEDGE AVE
City KALAMAZOO
State MI
ZIP 49008
Phone 269 552-1518
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Pharmacy
Lab Director CALEB H. VANDYKE

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