23D2060087 CLIA NUMBER - WALGREENS #04412

Laboratory Demographics

  • CLIA Code: 23D2060087
  • Facility Name: WALGREENS #04412
  • Facility Address: 1965 E BIG BEAVER ROAD
    TROY, MI
    ZIP 48083
  • Facility Phone: 248 526-9775
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MADHAVI V. PATIL
  • NPI Number: 1912912031
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2060087
LAB Type Pharmacy
Facility Name WALGREENS #04412
Street 1965 E BIG BEAVER ROAD
City TROY
State MI
ZIP 48083
Phone 248 526-9775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Pharmacy
Lab Director MADHAVI V. PATIL

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