23D2039853 CLIA NUMBER - WALGREENS #12534

Laboratory Demographics

  • CLIA Code: 23D2039853
  • Facility Name: WALGREENS #12534
  • Facility Address: 1301 N US HIGHWAY 31
    PETOSKEY, MI
    ZIP 49770
  • Facility Phone: 231 348-7510
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LANDRY C. CHANNELS
  • NPI Number: 1639326986
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2039853
LAB Type Pharmacy
Facility Name WALGREENS #12534
Street 1301 N US HIGHWAY 31
City PETOSKEY
State MI
ZIP 49770
Phone 231 348-7510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2023
Certificate Expiration Date 8/9/2025
Facility Type Pharmacy
Lab Director LANDRY C. CHANNELS

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