52D2015480 CLIA NUMBER - WALGREENS #07809

Laboratory Demographics

  • CLIA Code: 52D2015480
  • Facility Name: WALGREENS #07809
  • Facility Address: 2625 W NATIONAL AVE
    MILWAUKEE, WI
    ZIP 53204
  • Facility Phone: 414 383-4021
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. NICHOLAS OLSZEWSKI
  • NPI Number: 1669410023
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2015480
LAB Type Pharmacy
Facility Name WALGREENS #07809
Street 2625 W NATIONAL AVE
City MILWAUKEE
State WI
ZIP 53204
Phone 414 383-4021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type Pharmacy
Lab Director MR. NICHOLAS OLSZEWSKI

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