23D2059523 CLIA NUMBER - WALGREENS #12042

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Laboratory Demographics

CLIA Number: 23D2059523

Facility Name: WALGREENS #12042

Facility Address:
2901 CENTER AVENUE
ESSEXVILLE, MI
ZIP 48732
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Facility Phone Number: 989 894-4832

Facility Type: Other - COVID TESTING

Certificate Type: Waiver

NPI Number: 1073772109

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	23D2059523
LAB Type	Other - COVID TESTING
Facility Name	WALGREENS #12042
Street	2901 CENTER AVENUE
City	ESSEXVILLE
State	MI
ZIP	48732
Phone	989 894-4832
CertificateType	4
CertificateEffectiveDate	1/26/2023
CertificateExpirationDate	1/25/2025
FacilityType	Waiver

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