23D2149441 CLIA NUMBER - WALMART PHARMACY 10-1942

Laboratory Demographics

  • CLIA Code: 23D2149441
  • Facility Name: WALMART PHARMACY 10-1942
  • Facility Address: 2629 N PARK DRIVE
    HOLLAND, MI
    ZIP 49424
  • Facility Phone: 616 393-8071
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL SMITH
  • NPI Number: 1053339481
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149441
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1942
Street 2629 N PARK DRIVE
City HOLLAND
State MI
ZIP 49424
Phone 616 393-8071
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 MICHAEL SMITH

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