23D2279415 CLIA NUMBER - WOODWARD DETROIT CVS, LLC CVS/PHARMACY #08292

Laboratory Demographics

CLIA Number: 23D2279415

Facility Name: WOODWARD DETROIT CVS, LLC CVS/PHARMACY #08292

Facility Address:
1155 FULLER AVENUE NE
GRAND RAPIDS, MI
ZIP 49503
Get Directions

Facility Phone Number: 616 774-1041

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871693218

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	23D2279415
LAB Type	Pharmacy
Facility Name	WOODWARD DETROIT CVS, LLC CVS/PHARMACY #08292
Street	1155 FULLER AVENUE NE
City	GRAND RAPIDS
State	MI
ZIP	49503
Phone	616 774-1041
CertificateType	4
CertificateEffectiveDate	4/3/2023
CertificateExpirationDate	4/2/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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