52D2011829 CLIA NUMBER - WALGREENS #03578

Laboratory Demographics

  • CLIA Code: 52D2011829
  • Facility Name: WALGREENS #03578
  • Facility Address: 2275 N MAYFAIR RD
    WAUWATOSA, WI
    ZIP 53226
  • Facility Phone: 414 774-4821
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIN SMITH
  • NPI Number: 1275182925
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2011829
LAB Type Pharmacy
Facility Name WALGREENS #03578
Street 2275 N MAYFAIR RD
City WAUWATOSA
State WI
ZIP 53226
Phone 414 774-4821
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director KRISTIN SMITH

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