23D2149482 CLIA NUMBER - WALMART PHARMACY 10-2959

Laboratory Demographics

  • CLIA Code: 23D2149482
  • Facility Name: WALMART PHARMACY 10-2959
  • Facility Address: 28804 GRATIOT AVENUE
    ROSEVILLE, MI
    ZIP 48066
  • Facility Phone: 586 777-9475
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMED MOHAMED
  • NPI Number: 1376560599
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149482
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2959
Street 28804 GRATIOT AVENUE
City ROSEVILLE
State MI
ZIP 48066
Phone 586 777-9475
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 AHMED MOHAMED

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