23D2149439 CLIA NUMBER - WALMART PHARMACY 10-1923

Laboratory Demographics

  • CLIA Code: 23D2149439
  • Facility Name: WALMART PHARMACY 10-1923
  • Facility Address: 3999 ALPINE AVENUE NW
    COMSTOCK PARK, MI
    ZIP 49321
  • Facility Phone: 616 784-1619
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STACEY L. BERLIN
  • NPI Number: 1821015033
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149439
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1923
Street 3999 ALPINE AVENUE NW
City COMSTOCK PARK
State MI
ZIP 49321
Phone 616 784-1619
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 STACEY L. BERLIN

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