23D2100572 CLIA NUMBER - MEIJER PHARMACY #465

Laboratory Demographics

  • CLIA Code: 23D2100572
  • Facility Name: MEIJER PHARMACY #465
  • Facility Address: 100 MICHIGAN STREET NE SUITE 1830
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 249-6210
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1447635388
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2100572
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #465
Street 100 MICHIGAN STREET NE SUITE 1830
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 249-6210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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