23D2149516 CLIA NUMBER - WALMART PHARMACY 10-5842

Laboratory Demographics

  • CLIA Code: 23D2149516
  • Facility Name: WALMART PHARMACY 10-5842
  • Facility Address: 14900 DIX TOLEDO ROAD
    SOUTHGATE, MI
    ZIP 48195
  • Facility Phone: 734 286-9601
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MUHAMMAD B. JAWAD
  • NPI Number: 1295022416
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149516
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5842
Street 14900 DIX TOLEDO ROAD
City SOUTHGATE
State MI
ZIP 48195
Phone 734 286-9601
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 MUHAMMAD B. JAWAD

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