23D2059233 CLIA NUMBER - WALGREENS #04691

Laboratory Demographics

  • CLIA Code: 23D2059233
  • Facility Name: WALGREENS #04691
  • Facility Address: 26800 JOHN R ROAD
    MADISON HEIGHTS, MI
    ZIP 48071
  • Facility Phone: 248 546-2872
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ISTABRAK H. SARSAM
  • NPI Number: 1710992839
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2059233
LAB Type Pharmacy
Facility Name WALGREENS #04691
Street 26800 JOHN R ROAD
City MADISON HEIGHTS
State MI
ZIP 48071
Phone 248 546-2872
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 ISTABRAK H. SARSAM

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