23D2058816 CLIA NUMBER - WALGREENS #04864

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Laboratory Demographics

CLIA Number: 23D2058816

Facility Name: WALGREENS #04864

Facility Address:
7380 ORCHARD LAKE ROAD
WEST BLOOMFIELD, MI
ZIP 48322
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Facility Phone Number: 248 538-8373

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1154713907

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	23D2058816
LAB Type	Pharmacy
Facility Name	WALGREENS #04864
Street	7380 ORCHARD LAKE ROAD
City	WEST BLOOMFIELD
State	MI
ZIP	48322
Phone	248 538-8373
CertificateType	4
CertificateEffectiveDate	8/9/2023
CertificateExpirationDate	8/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024