23D2149492 CLIA NUMBER - WALMART PHARMACY 10-3476

Laboratory Demographics

  • CLIA Code: 23D2149492
  • Facility Name: WALMART PHARMACY 10-3476
  • Facility Address: 39500 FORD ROAD
    CANTON, MI
    ZIP 48187
  • Facility Phone: 734 983-0548
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALLISON KIEFIUK
  • NPI Number: 1275550493
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149492
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3476
Street 39500 FORD ROAD
City CANTON
State MI
ZIP 48187
Phone 734 983-0548
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 ALLISON KIEFIUK

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