23D2308475 CLIA NUMBER - MEDICINE TREE PHARMACY

Laboratory Demographics

  • CLIA Code: 23D2308475
  • Facility Name: MEDICINE TREE PHARMACY
  • Facility Address: 56109 VILLAGE CENTER CIRCLE
    MATTAWAN, MI
    ZIP 49071
  • Facility Phone: 269 668-6801
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOHAMED A. BEYDOUN
  • NPI Number: 1811468614
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2308475
LAB Type Pharmacy
Facility Name MEDICINE TREE PHARMACY
Street 56109 VILLAGE CENTER CIRCLE
City MATTAWAN
State MI
ZIP 49071
Phone 269 668-6801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Pharmacy
Lab Director MOHAMED A. BEYDOUN

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