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23D2255734 CLIA NUMBER - WOODWARD DETROIT CVS, LLC DBA CVS/PHARMACY #05610

Laboratory Demographics

CLIA Number: 23D2255734

Facility Name: WOODWARD DETROIT CVS, LLC DBA CVS/PHARMACY #05610

Facility Address:
3590 PLAINFIELD AVE NE
GRAND RAPIDS, MI
ZIP 49525
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1861796112

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 23D2255734
LAB Type Pharmacy
Facility Name WOODWARD DETROIT CVS, LLC DBA CVS/PHARMACY #05610
Street 3590 PLAINFIELD AVE NE
City GRAND RAPIDS
State MI
ZIP 49525
Phone 866 389-2727
CertificateType 4
CertificateEffectiveDate 3/17/2024
CertificateExpirationDate 3/16/2026
FacilityType Waiver

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