52D2015488 CLIA NUMBER - WALGREENS 09009

Laboratory Demographics

  • CLIA Code: 52D2015488
  • Facility Name: WALGREENS 09009
  • Facility Address: 3200 8TH ST S
    WISCONSIN RAPIDS, WI
    ZIP 54494
  • Facility Phone: 715 424-4082
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN T. KRAEMER
  • NPI Number: 1881609964
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2015488
LAB Type Pharmacy
Facility Name WALGREENS 09009
Street 3200 8TH ST S
City WISCONSIN RAPIDS
State WI
ZIP 54494
Phone 715 424-4082
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 JUSTIN T. KRAEMER

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