52D2030100 CLIA NUMBER - WALGREENS #10758

Laboratory Demographics

  • CLIA Code: 52D2030100
  • Facility Name: WALGREENS #10758
  • Facility Address: 110 LAKE SHORE DR W
    ASHLAND, WI
    ZIP 54806
  • Facility Phone: 715 685-0202
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARGARET J. WIESNER
  • NPI Number: 1861626087
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2030100
LAB Type Pharmacy
Facility Name WALGREENS #10758
Street 110 LAKE SHORE DR W
City ASHLAND
State WI
ZIP 54806
Phone 715 685-0202
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Pharmacy
Lab Director MARGARET J. WIESNER

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