23D2149500 CLIA NUMBER - WALMART PHARMACY 10-4383

Laboratory Demographics

  • CLIA Code: 23D2149500
  • Facility Name: WALMART PHARMACY 10-4383
  • Facility Address: 5851 MERCURY DRIVE
    DEARBORN, MI
    ZIP 48126
  • Facility Phone: 313 441-2841
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOHAMED A. FAKHERDDINE
  • NPI Number: 1851590335
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D2149500
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4383
Street 5851 MERCURY DRIVE
City DEARBORN
State MI
ZIP 48126
Phone 313 441-2841
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 MOHAMED A. FAKHERDDINE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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