23D2149477 CLIA NUMBER - WALMART PHARMACY 10-2692

Laboratory Demographics

  • CLIA Code: 23D2149477
  • Facility Name: WALMART PHARMACY 10-2692
  • Facility Address: 45400 MARKETPLACE BLVD
    CHESTERFIELD, MI
    ZIP 48051
  • Facility Phone: 586 421-1265
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FATHI S. ABDULLAH
  • NPI Number: 1720005945
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149477
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2692
Street 45400 MARKETPLACE BLVD
City CHESTERFIELD
State MI
ZIP 48051
Phone 586 421-1265
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 FATHI S. ABDULLAH

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