52D2012895 CLIA NUMBER - WALGREENS 01685

Laboratory Demographics

  • CLIA Code: 52D2012895
  • Facility Name: WALGREENS 01685
  • Facility Address: 1400 E BRADY ST
    MILWAUKEE, WI
    ZIP 53202
  • Facility Phone: 414 272-2171
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATHAN E. VOMHOF
  • NPI Number: 1912912817
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2012895
LAB Type Pharmacy
Facility Name WALGREENS 01685
Street 1400 E BRADY ST
City MILWAUKEE
State WI
ZIP 53202
Phone 414 272-2171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director NATHAN E. VOMHOF

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