23D2042390 CLIA NUMBER - WALGREENS #03012

Laboratory Demographics

  • CLIA Code: 23D2042390
  • Facility Name: WALGREENS #03012
  • Facility Address: 3191 28TH STREET S W
    GRANDVILLE, MI
    ZIP 49418
  • Facility Phone: 616 534-5533
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES T. CAIRNS
  • NPI Number: 1639186653
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2042390
LAB Type Pharmacy
Facility Name WALGREENS #03012
Street 3191 28TH STREET S W
City GRANDVILLE
State MI
ZIP 49418
Phone 616 534-5533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director CHARLES T. CAIRNS

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