52D2012227 CLIA NUMBER - WALGREENS 04055

Laboratory Demographics

  • CLIA Code: 52D2012227
  • Facility Name: WALGREENS 04055
  • Facility Address: 1717 MILTON AVE
    JANESVILLE, WI
    ZIP 53545
  • Facility Phone: 608 754-2278
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIANA E. OESTREICHER
  • NPI Number: 1558376442
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2012227
LAB Type Pharmacy
Facility Name WALGREENS 04055
Street 1717 MILTON AVE
City JANESVILLE
State WI
ZIP 53545
Phone 608 754-2278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director BRIANA E. OESTREICHER

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