23D2084271 CLIA NUMBER - VG'S PHARMACY #1934

Laboratory Demographics

  • CLIA Code: 23D2084271
  • Facility Name: VG'S PHARMACY #1934
  • Facility Address: 6764 S RIVER ROAD
    MARINE CITY, MI
    ZIP 48039
  • Facility Phone: 810 765-3585
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY ELLIS
  • NPI Number: 1417192113
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2084271
LAB Type Pharmacy
Facility Name VG'S PHARMACY #1934
Street 6764 S RIVER ROAD
City MARINE CITY
State MI
ZIP 48039
Phone 810 765-3585
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Pharmacy
Lab Director AMY ELLIS

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