52D2033329 CLIA NUMBER - WALGREENS #11857

Laboratory Demographics

  • CLIA Code: 52D2033329
  • Facility Name: WALGREENS #11857
  • Facility Address: 10489 STATE ROAD 27
    HAYWARD, WI
    ZIP 54843
  • Facility Phone: 715 634-1919
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. JASON LAU
  • NPI Number: 1356505044
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2033329
LAB Type Pharmacy
Facility Name WALGREENS #11857
Street 10489 STATE ROAD 27
City HAYWARD
State WI
ZIP 54843
Phone 715 634-1919
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director DR. JASON LAU

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