23D2042399 CLIA NUMBER - WALGREENS #11310

Laboratory Demographics

  • CLIA Code: 23D2042399
  • Facility Name: WALGREENS #11310
  • Facility Address: 1525 MANISTEE HIGHWAY 31 S
    MANISTEE, MI
    ZIP 49660
  • Facility Phone: 231 398-0348
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN L. POORT
  • NPI Number: 1033306956
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2042399
LAB Type Pharmacy
Facility Name WALGREENS #11310
Street 1525 MANISTEE HIGHWAY 31 S
City MANISTEE
State MI
ZIP 49660
Phone 231 398-0348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director RYAN L. POORT

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