23D2042397 CLIA NUMBER - WALGREENS #11249

Laboratory Demographics

  • CLIA Code: 23D2042397
  • Facility Name: WALGREENS #11249
  • Facility Address: 1550 36TH STREET SW
    WYOMING, MI
    ZIP 49509
  • Facility Phone: 616 249-7887
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHLOE C. MASTERSON
  • NPI Number: 1538174644
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2042397
LAB Type Pharmacy
Facility Name WALGREENS #11249
Street 1550 36TH STREET SW
City WYOMING
State MI
ZIP 49509
Phone 616 249-7887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Pharmacy
Lab Director CHLOE C. MASTERSON

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