23D2061261 CLIA NUMBER - WALGREENS #10778

Laboratory Demographics

  • CLIA Code: 23D2061261
  • Facility Name: WALGREENS #10778
  • Facility Address: 22318 PONTIAC TRAIL
    SOUTH LYON, MI
    ZIP 48178
  • Facility Phone: 248 486-5216
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: BHAVESH PATEL
  • NPI Number: 1003098344
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2061261
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #10778
Street 22318 PONTIAC TRAIL
City SOUTH LYON
State MI
ZIP 48178
Phone 248 486-5216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director BHAVESH PATEL

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