23D2149510 CLIA NUMBER - WALMART PHARMACY 10-5048

Laboratory Demographics

  • CLIA Code: 23D2149510
  • Facility Name: WALMART PHARMACY 10-5048
  • Facility Address: 30729 LYON CENTER DR E
    NEW HUDSON, MI
    ZIP 48165
  • Facility Phone: 248 486-1953
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AYA AL-ANANI
  • NPI Number: 1447277660
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149510
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5048
Street 30729 LYON CENTER DR E
City NEW HUDSON
State MI
ZIP 48165
Phone 248 486-1953
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 AYA AL-ANANI

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