23D2056770 CLIA NUMBER - WALGREENS #11286

Laboratory Demographics

  • CLIA Code: 23D2056770
  • Facility Name: WALGREENS #11286
  • Facility Address: 2131 W GRAND RIVER AVENUE
    OKEMOS, MI
    ZIP 48864
  • Facility Phone: 517 347-4632
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MACKENZIE J. GRULKE
  • NPI Number: 1588932354
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2056770
LAB Type Pharmacy
Facility Name WALGREENS #11286
Street 2131 W GRAND RIVER AVENUE
City OKEMOS
State MI
ZIP 48864
Phone 517 347-4632
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director MACKENZIE J. GRULKE

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