23D2149479 CLIA NUMBER - WALMART PHARMACY 10-2700

Laboratory Demographics

  • CLIA Code: 23D2149479
  • Facility Name: WALMART PHARMACY 10-2700
  • Facility Address: 9190 HIGHLAND ROAD
    WHITE LAKE, MI
    ZIP 48386
  • Facility Phone: 248 698-9680
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MIRNA KAKKA
  • NPI Number: 1194742312
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149479
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2700
Street 9190 HIGHLAND ROAD
City WHITE LAKE
State MI
ZIP 48386
Phone 248 698-9680
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 MIRNA KAKKA

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