23D2041141 CLIA NUMBER - WALGREENS #10804

Laboratory Demographics

  • CLIA Code: 23D2041141
  • Facility Name: WALGREENS #10804
  • Facility Address: 7420 SECOR ROAD
    LAMBERTVILLE, MI
    ZIP 48144
  • Facility Phone: 734 856-2083
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMIE L. MANGAS
  • NPI Number: 1437325636
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2041141
LAB Type Pharmacy
Facility Name WALGREENS #10804
Street 7420 SECOR ROAD
City LAMBERTVILLE
State MI
ZIP 48144
Phone 734 856-2083
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Pharmacy
Lab Director JAMIE L. MANGAS

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