52D2022688 CLIA NUMBER - WALGREENS #11301

Laboratory Demographics

  • CLIA Code: 52D2022688
  • Facility Name: WALGREENS #11301
  • Facility Address: 981 N SHAWANO ST
    NEW LONDON, WI
    ZIP 54961
  • Facility Phone: 920 982-5189
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER M. BETTS
  • NPI Number: 1871787598
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2022688
LAB Type Pharmacy
Facility Name WALGREENS #11301
Street 981 N SHAWANO ST
City NEW LONDON
State WI
ZIP 54961
Phone 920 982-5189
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director JENNIFER M. BETTS

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