23D2038322 CLIA NUMBER - WALGREENS #11265

Laboratory Demographics

  • CLIA Code: 23D2038322
  • Facility Name: WALGREENS #11265
  • Facility Address: 1710 W JOHN BEERS ROAD
    STEVENSVILLE, MI
    ZIP 49127
  • Facility Phone: 269 429-1153
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAIGE N. DOMMER
  • NPI Number: 1700073913
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2038322
LAB Type Pharmacy
Facility Name WALGREENS #11265
Street 1710 W JOHN BEERS ROAD
City STEVENSVILLE
State MI
ZIP 49127
Phone 269 429-1153
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2023
Certificate Expiration Date 8/23/2025
Facility Type Pharmacy
Lab Director PAIGE N. DOMMER

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This page was last updated on: 3/20/2025