52D2015809 CLIA NUMBER - WALGREENS #02911

Laboratory Demographics

  • CLIA Code: 52D2015809
  • Facility Name: WALGREENS #02911
  • Facility Address: 6292 S 27TH ST
    MILWAUKEE, WI
    ZIP 53221
  • Facility Phone: 414 761-0994
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. STEVEN PENN
  • NPI Number: 1952316002
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2015809
LAB Type Pharmacy
Facility Name WALGREENS #02911
Street 6292 S 27TH ST
City MILWAUKEE
State WI
ZIP 53221
Phone 414 761-0994
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Pharmacy
Lab Director DR. STEVEN PENN

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