23D2058758 CLIA NUMBER - WALGREENS #05595

Laboratory Demographics

  • CLIA Code: 23D2058758
  • Facility Name: WALGREENS #05595
  • Facility Address: 1617 10TH STREET
    PORT HURON, MI
    ZIP 48060
  • Facility Phone: 810 987-5083
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHERYL V. LINDOW
  • NPI Number: 1730194861
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2058758
LAB Type Pharmacy
Facility Name WALGREENS #05595
Street 1617 10TH STREET
City PORT HURON
State MI
ZIP 48060
Phone 810 987-5083
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Pharmacy
Lab Director CHERYL V. LINDOW

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