23D2058761 CLIA NUMBER - WALGREENS #04453

Laboratory Demographics

  • CLIA Code: 23D2058761
  • Facility Name: WALGREENS #04453
  • Facility Address: 47100 HAYES ROAD
    MACOMB, MI
    ZIP 48044
  • Facility Phone: 586 532-8161
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VIJAYKUMAR G. PATEL
  • NPI Number: 1639184757
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2058761
LAB Type Pharmacy
Facility Name WALGREENS #04453
Street 47100 HAYES ROAD
City MACOMB
State MI
ZIP 48044
Phone 586 532-8161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Pharmacy
Lab Director VIJAYKUMAR G. PATEL

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