52D2022873 CLIA NUMBER - WALGREENS #11277

Laboratory Demographics

  • CLIA Code: 52D2022873
  • Facility Name: WALGREENS #11277
  • Facility Address: 333 PHILLIPS BLVD
    SAUK CITY, WI
    ZIP 53583
  • Facility Phone: 608 643-5182
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMIN D. CARLSON
  • NPI Number: 1275701047
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2022873
LAB Type Pharmacy
Facility Name WALGREENS #11277
Street 333 PHILLIPS BLVD
City SAUK CITY
State WI
ZIP 53583
Phone 608 643-5182
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 JAMIN D. CARLSON

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