23D2158006 CLIA NUMBER - ST CLAIR SHORE PHARMACY MI LLC

Laboratory Demographics

  • CLIA Code: 23D2158006
  • Facility Name: ST CLAIR SHORE PHARMACY MI LLC
  • Facility Address: 25014 LITTLE MACK AVENUE
    SAINT CLAIR SHORES, MI
    ZIP 48080
  • Facility Phone: 586 359-6517
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAHARI PATEL
  • NPI Number: 1104260066
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2158006
LAB Type Pharmacy
Facility Name ST CLAIR SHORE PHARMACY MI LLC
Street 25014 LITTLE MACK AVENUE
City SAINT CLAIR SHORES
State MI
ZIP 48080
Phone 586 359-6517
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 LAHARI PATEL

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