23D2053821 CLIA NUMBER - WALGREENS #02581

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Laboratory Demographics

CLIA Number: 23D2053821

Facility Name: WALGREENS #02581

Facility Address:
1601 KALAMAZOO AVENUE SE
GRAND RAPIDS, MI
ZIP 49507
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Facility Phone Number: 616 247-5521

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1710992011

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	23D2053821
LAB Type	Pharmacy
Facility Name	WALGREENS #02581
Street	1601 KALAMAZOO AVENUE SE
City	GRAND RAPIDS
State	MI
ZIP	49507
Phone	616 247-5521
CertificateType	4
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024