23D2058767 CLIA NUMBER - WALGREENS #09928

Laboratory Demographics

  • CLIA Code: 23D2058767
  • Facility Name: WALGREENS #09928
  • Facility Address: 20 S TELEGRAPH ROAD
    WATERFORD, MI
    ZIP 48328
  • Facility Phone: 248 681-7636
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOHAMED ALLAM
  • NPI Number: 1548443427
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2058767
LAB Type Pharmacy
Facility Name WALGREENS #09928
Street 20 S TELEGRAPH ROAD
City WATERFORD
State MI
ZIP 48328
Phone 248 681-7636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Pharmacy
Lab Director MOHAMED ALLAM

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