23D2042402 CLIA NUMBER - WALGREENS #11801

Laboratory Demographics

  • CLIA Code: 23D2042402
  • Facility Name: WALGREENS #11801
  • Facility Address: 5575 BYRON CENTER AVENUE S W
    WYOMING, MI
    ZIP 49519
  • Facility Phone: 616 534-5175
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEVIN J. ROSE
  • NPI Number: 1225215254
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2042402
LAB Type Pharmacy
Facility Name WALGREENS #11801
Street 5575 BYRON CENTER AVENUE S W
City WYOMING
State MI
ZIP 49519
Phone 616 534-5175
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Pharmacy
Lab Director DEVIN J. ROSE

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