23D2149437 CLIA NUMBER - WALMART PHARMACY 10-1791

Laboratory Demographics

  • CLIA Code: 23D2149437
  • Facility Name: WALMART PHARMACY 10-1791
  • Facility Address: 7083 W 48TH STREET
    FREMONT, MI
    ZIP 49412
  • Facility Phone: 231 924-6900
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACOB KEEVAN
  • NPI Number: 1568489771
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149437
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1791
Street 7083 W 48TH STREET
City FREMONT
State MI
ZIP 49412
Phone 231 924-6900
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 JACOB KEEVAN

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