23D2058777 CLIA NUMBER - WALGREENS #04676

Laboratory Demographics

  • CLIA Code: 23D2058777
  • Facility Name: WALGREENS #04676
  • Facility Address: 5703 S SAGINAW ROAD
    GRAND BLANC, MI
    ZIP 48507
  • Facility Phone: (810) 695-4623
  • Facility Type: Other - COVID TESTING
  • Facility Type: Waiver
  • Lab Director: HIRANKUMAR I. AMIN
  • NPI Number: 1548275662
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2058777
LAB Type Other - COVID TESTING
Facility Name WALGREENS #04676
Street 5703 S SAGINAW ROAD
City GRAND BLANC
State MI
ZIP 48507
Phone 8106954623
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Other - COVID TESTING
Lab Director HIRANKUMAR I. AMIN

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This page was last updated on: 5/18/2026