23D2063726 CLIA NUMBER - WALGREENS #04498

Laboratory Demographics

  • CLIA Code: 23D2063726
  • Facility Name: WALGREENS #04498
  • Facility Address: 20090 GODDARD ROAD
    TAYLOR, MI
    ZIP 48180
  • Facility Phone: 313 299-1584
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WAFA A. MOUGHNI AYAD
  • NPI Number: 1285649301
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2063726
LAB Type Pharmacy
Facility Name WALGREENS #04498
Street 20090 GODDARD ROAD
City TAYLOR
State MI
ZIP 48180
Phone 313 299-1584
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Pharmacy
Lab Director WAFA A. MOUGHNI AYAD

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