23D2097532 CLIA NUMBER - WALMART PHARMACY 10-1733

Laboratory Demographics

  • CLIA Code: 23D2097532
  • Facility Name: WALMART PHARMACY 10-1733
  • Facility Address: 1621 EAST M 21
    OWOSSO, MI
    ZIP 48867
  • Facility Phone: 989 723-2656
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH D. BICKEL
  • NPI Number: 1689692006
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2097532
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1733
Street 1621 EAST M 21
City OWOSSO
State MI
ZIP 48867
Phone 989 723-2656
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type Pharmacy
Lab Director KENNETH D. BICKEL

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