23D2149475 CLIA NUMBER - WALMART PHARMACY 10-2631

Laboratory Demographics

  • CLIA Code: 23D2149475
  • Facility Name: WALMART PHARMACY 10-2631
  • Facility Address: 29555 PLYMOUTH ROAD
    LIVONIA, MI
    ZIP 48150
  • Facility Phone: 734 524-0568
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON K. REISS
  • NPI Number: 1659398873
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149475
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2631
Street 29555 PLYMOUTH ROAD
City LIVONIA
State MI
ZIP 48150
Phone 734 524-0568
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 BRANDON K. REISS

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