23D2061275 CLIA NUMBER - WALGREENS #11197

Laboratory Demographics

  • CLIA Code: 23D2061275
  • Facility Name: WALGREENS #11197
  • Facility Address: 2355 JACKSON AVE
    ANN ARBOR, MI
    ZIP 48103
  • Facility Phone: 810 923-6999
  • Facility Type: Other - COVID 19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: RYAN F. GRANT
  • NPI Number: 1407161417
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2061275
LAB Type Other - COVID 19 TEST SITE
Facility Name WALGREENS #11197
Street 2355 JACKSON AVE
City ANN ARBOR
State MI
ZIP 48103
Phone 810 923-6999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Other - COVID 19 TEST SITE
Lab Director RYAN F. GRANT

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