23D2059920 CLIA NUMBER - WALGREENS #04501

Laboratory Demographics

  • CLIA Code: 23D2059920
  • Facility Name: WALGREENS #04501
  • Facility Address: 22380 MOROSS ROAD
    DETROIT, MI
    ZIP 48236
  • Facility Phone: 313 642-1129
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHAVNEET KAUR
  • NPI Number: 1730194853
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2059920
LAB Type Pharmacy
Facility Name WALGREENS #04501
Street 22380 MOROSS ROAD
City DETROIT
State MI
ZIP 48236
Phone 313 642-1129
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2025
Certificate Expiration Date 7/29/2027
Facility Type Pharmacy
Lab Director SHAVNEET KAUR

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