23D2149434 CLIA NUMBER - WALMART PHARMACY 10-1611

Laboratory Demographics

  • CLIA Code: 23D2149434
  • Facility Name: WALMART PHARMACY 10-1611
  • Facility Address: 4845 24TH AVENUE
    FORT GRATIOT, MI
    ZIP 48059
  • Facility Phone: 810 385-7747
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WESLEY SCHIEMAN
  • NPI Number: 1639196942
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149434
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1611
Street 4845 24TH AVENUE
City FORT GRATIOT
State MI
ZIP 48059
Phone 810 385-7747
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2024
Certificate Expiration Date 6/4/2026
Facility Type Pharmacy
Lab Director WESLEY SCHIEMAN

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