23D2084485 CLIA NUMBER - FAMILY FARE PHARMACY #339

Laboratory Demographics

  • CLIA Code: 23D2084485
  • Facility Name: FAMILY FARE PHARMACY #339
  • Facility Address: 2755 LAKE MICHIGAN DRIVE NW
    GRAND RAPIDS, MI
    ZIP 49504
  • Facility Phone: 616 791-4777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY ELLIS
  • NPI Number: 1679673909
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2084485
LAB Type Pharmacy
Facility Name FAMILY FARE PHARMACY #339
Street 2755 LAKE MICHIGAN DRIVE NW
City GRAND RAPIDS
State MI
ZIP 49504
Phone 616 791-4777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Pharmacy
Lab Director AMY ELLIS

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This page was last updated on: 3/20/2025