52D0996919 CLIA NUMBER - WALGREENS STORE #03109

Laboratory Demographics

  • CLIA Code: 52D0996919
  • Facility Name: WALGREENS STORE #03109
  • Facility Address: 7171 N TEUTONIA AVE
    MILWAUKEE, WI
    ZIP 53209
  • Facility Phone: 414 351-2538
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DOUANENG LEE
  • NPI Number: 1801803796
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D0996919
LAB Type Pharmacy
Facility Name WALGREENS STORE #03109
Street 7171 N TEUTONIA AVE
City MILWAUKEE
State WI
ZIP 53209
Phone 414 351-2538
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Pharmacy
Lab Director DOUANENG LEE

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