23D2207358 CLIA NUMBER - CANADIAN LAKES PHARMACY

Laboratory Demographics

  • CLIA Code: 23D2207358
  • Facility Name: CANADIAN LAKES PHARMACY
  • Facility Address: 10075 BUCHANAN RD
    STANWOOD, MI
    ZIP 49346
  • Facility Phone: 231 359-1661
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRENT D. BEEMER
  • NPI Number: 1972086981
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2207358
LAB Type Pharmacy
Facility Name CANADIAN LAKES PHARMACY
Street 10075 BUCHANAN RD
City STANWOOD
State MI
ZIP 49346
Phone 231 359-1661
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2024
Certificate Expiration Date 6/25/2026
Facility Type Pharmacy
Lab Director BRENT D. BEEMER

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