52D2012219 CLIA NUMBER - WALGREENS #02848

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Laboratory Demographics

CLIA Number: 52D2012219

Facility Name: WALGREENS #02848

Facility Address:
606 S WHITNEY WAY
MADISON, WI
ZIP 53711
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Facility Phone Number: 608 274-1311

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1366457426

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	52D2012219
LAB Type	Pharmacy
Facility Name	WALGREENS #02848
Street	606 S WHITNEY WAY
City	MADISON
State	WI
ZIP	53711
Phone	608 274-1311
CertificateType	4
CertificateEffectiveDate	5/13/2023
CertificateExpirationDate	5/12/2025
FacilityType	Waiver

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