52D0391167 CLIA NUMBER - ASC CSM MILWAUKEE HOSPITAL AT BROWN DEER

Laboratory Demographics

CLIA Number: 52D0391167

Facility Name: ASC CSM MILWAUKEE HOSPITAL AT BROWN DEER

Facility Address:
9252 N GREEN BAY ROAD, 2ND FLOOR
BROWN DEER, WI
ZIP 53209
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Facility Phone Number: 414 527-7500

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1427517408

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	52D0391167
LAB Type	Physician Office
Facility Name	ASC CSM MILWAUKEE HOSPITAL AT BROWN DEER
Street	9252 N GREEN BAY ROAD, 2ND FLOOR
City	BROWN DEER
State	WI
ZIP	53209
Phone	414 527-7500
CertificateType	3
CertificateEffectiveDate	7/13/2023
CertificateExpirationDate	7/12/2025
FacilityType	PPMP

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