23D2041147 CLIA NUMBER - WALGREENS #12561

Laboratory Demographics

  • CLIA Code: 23D2041147
  • Facility Name: WALGREENS #12561
  • Facility Address: 4550 CASCADE ROAD SE
    GRAND RAPIDS, MI
    ZIP 49546
  • Facility Phone: 616 957-8934
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MEGAN LENIHAN
  • NPI Number: 1518223403
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2041147
LAB Type Pharmacy
Facility Name WALGREENS #12561
Street 4550 CASCADE ROAD SE
City GRAND RAPIDS
State MI
ZIP 49546
Phone 616 957-8934
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director MEGAN LENIHAN

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