23D2247090 CLIA NUMBER - WARRIORS PHARMACY

Laboratory Demographics

CLIA Number: 23D2247090

Facility Name: WARRIORS PHARMACY

Facility Address:
5265 ANTHONY WAYNE DRIVE
DETROIT, MI
ZIP 48202
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Facility Phone Number: 313 774-0520

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1669012316

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	23D2247090
LAB Type	Pharmacy
Facility Name	WARRIORS PHARMACY
Street	5265 ANTHONY WAYNE DRIVE
City	DETROIT
State	MI
ZIP	48202
Phone	313 774-0520
CertificateType	4
CertificateEffectiveDate	1/4/2024
CertificateExpirationDate	1/3/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024