23D2084473 CLIA NUMBER - FAMILY FARE PHARMACY #123

Laboratory Demographics

  • CLIA Code: 23D2084473
  • Facility Name: FAMILY FARE PHARMACY #123
  • Facility Address: 1185 S WASHINGTON AVENUE
    HOLLAND, MI
    ZIP 49423
  • Facility Phone: 616 392-7504
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY ELLIS
  • NPI Number: 1023118353
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D2084473
LAB Type Pharmacy
Facility Name FAMILY FARE PHARMACY #123
Street 1185 S WASHINGTON AVENUE
City HOLLAND
State MI
ZIP 49423
Phone 616 392-7504
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

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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