23D2059233 CLIA NUMBER - WALGREENS #04691

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Laboratory Demographics

CLIA Number: 23D2059233

Facility Name: WALGREENS #04691

Facility Address:
26800 JOHN R ROAD
MADISON HEIGHTS, MI
ZIP 48071
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Facility Phone Number: 248 546-2872

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1710992839

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType	4
CertificateEffectiveDate	6/1/2023
CertificateExpirationDate	5/31/2025
FacilityType	Waiver

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