52D2013555 CLIA NUMBER - WALGREENS 03064

Laboratory Demographics

  • CLIA Code: 52D2013555
  • Facility Name: WALGREENS 03064
  • Facility Address: 2015 TOWER AVE
    SUPERIOR, WI
    ZIP 54880
  • Facility Phone: 715 392-9550
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RONALD S. HARLANDER JR
  • NPI Number: 1215942362
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2013555
LAB Type Pharmacy
Facility Name WALGREENS 03064
Street 2015 TOWER AVE
City SUPERIOR
State WI
ZIP 54880
Phone 715 392-9550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Pharmacy
Lab Director RONALD S. HARLANDER JR

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