23D2084449 CLIA NUMBER - FAMILY FARE PHARMACY #1524

Laboratory Demographics

  • CLIA Code: 23D2084449
  • Facility Name: FAMILY FARE PHARMACY #1524
  • Facility Address: 1204 N STATE STREET
    GLADWIN, MI
    ZIP 48624
  • Facility Phone: 989 426-8608
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY ELLIS
  • NPI Number: 1184902090
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2084449
LAB Type Pharmacy
Facility Name FAMILY FARE PHARMACY #1524
Street 1204 N STATE STREET
City GLADWIN
State MI
ZIP 48624
Phone 989 426-8608
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Pharmacy
Lab Director AMY ELLIS

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