23D2059910 CLIA NUMBER - WALGREENS #04308

Laboratory Demographics

  • CLIA Code: 23D2059910
  • Facility Name: WALGREENS #04308
  • Facility Address: 32201 HARPER AVENUE
    SAINT CLAIR SHORES, MI
    ZIP 48082
  • Facility Phone: 586 293-5152
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISHNA VANGANUR
  • NPI Number: 1467467589
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2059910
LAB Type Pharmacy
Facility Name WALGREENS #04308
Street 32201 HARPER AVENUE
City SAINT CLAIR SHORES
State MI
ZIP 48082
Phone 586 293-5152
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Pharmacy
Lab Director KRISHNA VANGANUR

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