52D2015327 CLIA NUMBER - WALGREENS #04672

Laboratory Demographics

  • CLIA Code: 52D2015327
  • Facility Name: WALGREENS #04672
  • Facility Address: 2205 N CALHOUN RD
    BROOKFIELD, WI
    ZIP 53005
  • Facility Phone: 262 782-3120
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. STEVEN GOLL
  • NPI Number: 1275540155
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2015327
LAB Type Pharmacy
Facility Name WALGREENS #04672
Street 2205 N CALHOUN RD
City BROOKFIELD
State WI
ZIP 53005
Phone 262 782-3120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Pharmacy
Lab Director MR. STEVEN GOLL

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