23D2041133 CLIA NUMBER - WALGREENS #10515

Laboratory Demographics

  • CLIA Code: 23D2041133
  • Facility Name: WALGREENS #10515
  • Facility Address: 780 WASHINGTON AVE
    HOLLAND, MI
    ZIP 49423
  • Facility Phone: 616 396-0098
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TREVOR A. HOFMAN
  • NPI Number: 1992710008
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2041133
LAB Type Pharmacy
Facility Name WALGREENS #10515
Street 780 WASHINGTON AVE
City HOLLAND
State MI
ZIP 49423
Phone 616 396-0098
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 TREVOR A. HOFMAN

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