23D2264245 CLIA NUMBER - ADA VILLAGE PHARMACY

Laboratory Demographics

  • CLIA Code: 23D2264245
  • Facility Name: ADA VILLAGE PHARMACY
  • Facility Address: 7505 RIVER STREET SE SUITE 108
    ADA, MI
    ZIP 49301
  • Facility Phone: (616) 320-4001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW P. CLOUTIER
  • NPI Number: 1588236004
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2264245
LAB Type Pharmacy
Facility Name ADA VILLAGE PHARMACY
Street 7505 RIVER STREET SE SUITE 108
City ADA
State MI
ZIP 49301
Phone 6163204001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Pharmacy
Lab Director ANDREW P. CLOUTIER

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This page was last updated on: 5/18/2026