52D2023444 CLIA NUMBER - WALGREENS #04887

Laboratory Demographics

  • CLIA Code: 52D2023444
  • Facility Name: WALGREENS #04887
  • Facility Address: 9449 S HOWELL AVE
    OAK CREEK, WI
    ZIP 53154
  • Facility Phone: 414 764-8980
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NHAN T. VU
  • NPI Number: 1053326108
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2023444
LAB Type Pharmacy
Facility Name WALGREENS #04887
Street 9449 S HOWELL AVE
City OAK CREEK
State WI
ZIP 53154
Phone 414 764-8980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Pharmacy
Lab Director NHAN T. VU

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