23D2054539 CLIA NUMBER - WALGREENS #10081

Laboratory Demographics

  • CLIA Code: 23D2054539
  • Facility Name: WALGREENS #10081
  • Facility Address: 5933 S WESTNEDGE AVENUE
    PORTAGE, MI
    ZIP 49002
  • Facility Phone: 269 381-4862
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SELENA BOWEN
  • NPI Number: 1699897835
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2054539
LAB Type Pharmacy
Facility Name WALGREENS #10081
Street 5933 S WESTNEDGE AVENUE
City PORTAGE
State MI
ZIP 49002
Phone 269 381-4862
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Pharmacy
Lab Director SELENA BOWEN

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