23D2040405 CLIA NUMBER - WALGREENS #02825

Laboratory Demographics

  • CLIA Code: 23D2040405
  • Facility Name: WALGREENS #02825
  • Facility Address: 11236 E LAKEWOOD BLVD
    HOLLAND, MI
    ZIP 49424
  • Facility Phone: 616 396-5523
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JALEN BURTON
  • NPI Number: 1720095748
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2040405
LAB Type Pharmacy
Facility Name WALGREENS #02825
Street 11236 E LAKEWOOD BLVD
City HOLLAND
State MI
ZIP 49424
Phone 616 396-5523
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Pharmacy
Lab Director JALEN BURTON

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