52D2015672 CLIA NUMBER - WALGREENS #05280

Laboratory Demographics

  • CLIA Code: 52D2015672
  • Facility Name: WALGREENS #05280
  • Facility Address: 950 S KOELLER ST
    OSHKOSH, WI
    ZIP 54902
  • Facility Phone: 920 303-1712
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS CIRRICIONE
  • NPI Number: 1710992870
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2015672
LAB Type Pharmacy
Facility Name WALGREENS #05280
Street 950 S KOELLER ST
City OSHKOSH
State WI
ZIP 54902
Phone 920 303-1712
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Pharmacy
Lab Director NICHOLAS CIRRICIONE

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