23D2136198 CLIA NUMBER - WALMART PHARMACY 10-2417

Laboratory Demographics

  • CLIA Code: 23D2136198
  • Facility Name: WALMART PHARMACY 10-2417
  • Facility Address: 1850 ANDERSON ROAD
    PETOSKEY, MI
    ZIP 49770
  • Facility Phone: 231 439-0071
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRETT A. CUPER
  • NPI Number: 1275550485
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D2136198
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2417
Street 1850 ANDERSON ROAD
City PETOSKEY
State MI
ZIP 49770
Phone 231 439-0071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Pharmacy
Lab Director BRETT A. CUPER

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