23D2061270 CLIA NUMBER - WALGREENS #05842

Laboratory Demographics

  • CLIA Code: 23D2061270
  • Facility Name: WALGREENS #05842
  • Facility Address: 3255 WASHTENAW AVENUE
    ANN ARBOR, MI
    ZIP 48104
  • Facility Phone: 734 975-2902
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAY H. KIM
  • NPI Number: 1013922152
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2061270
LAB Type Pharmacy
Facility Name WALGREENS #05842
Street 3255 WASHTENAW AVENUE
City ANN ARBOR
State MI
ZIP 48104
Phone 734 975-2902
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2025
Certificate Expiration Date 10/19/2027
Facility Type Pharmacy
Lab Director JAY H. KIM

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