52D2012216 CLIA NUMBER - WALGREENS #03291

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Laboratory Demographics

CLIA Number: 52D2012216

Facility Name: WALGREENS #03291

Facility Address:
275 DAVISON DR
SUN PRAIRIE, WI
ZIP 53590
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Facility Phone Number: 608 837-8566

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1437340486

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	52D2012216
LAB Type	Pharmacy
Facility Name	WALGREENS #03291
Street	275 DAVISON DR
City	SUN PRAIRIE
State	WI
ZIP	53590
Phone	608 837-8566
CertificateType	4
CertificateEffectiveDate	3/30/2023
CertificateExpirationDate	3/29/2025
FacilityType	Waiver

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