23D2158004 CLIA NUMBER - FENTON PHARMACY RX MI LLC

Laboratory Demographics

  • CLIA Code: 23D2158004
  • Facility Name: FENTON PHARMACY RX MI LLC
  • Facility Address: 305 N LEROY STREET SUITE A
    FENTON, MI
    ZIP 48430
  • Facility Phone: 810 354-8500
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARTAJ BALDWAN
  • NPI Number: 1922690064
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2158004
LAB Type Pharmacy
Facility Name FENTON PHARMACY RX MI LLC
Street 305 N LEROY STREET SUITE A
City FENTON
State MI
ZIP 48430
Phone 810 354-8500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Pharmacy
Lab Director SARTAJ BALDWAN

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