52D0716936 CLIA NUMBER - BOSCOBEL PHARMACY INC

Laboratory Demographics

  • CLIA Code: 52D0716936
  • Facility Name: BOSCOBEL PHARMACY INC
  • Facility Address: 1028 WISCONSIN AVENUE
    BOSCOBEL, WI
    ZIP 53805
  • Facility Phone: 608 375-4466
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. MICHELLE E. FARRELL
  • NPI Number: 1245249614
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D0716936
LAB Type Pharmacy
Facility Name BOSCOBEL PHARMACY INC
Street 1028 WISCONSIN AVENUE
City BOSCOBEL
State WI
ZIP 53805
Phone 608 375-4466
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Pharmacy
Lab Director MS. MICHELLE E. FARRELL

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