52D2043292 CLIA NUMBER - WALGREENS #09549

Laboratory Demographics

  • CLIA Code: 52D2043292
  • Facility Name: WALGREENS #09549
  • Facility Address: 5400 N PORT WASHINGTON RD
    GLENDALE, WI
    ZIP 53217
  • Facility Phone: 414 967-0457
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TABARIUS L. SMITH
  • NPI Number: 1447267323
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2043292
LAB Type Pharmacy
Facility Name WALGREENS #09549
Street 5400 N PORT WASHINGTON RD
City GLENDALE
State WI
ZIP 53217
Phone 414 967-0457
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director TABARIUS L. SMITH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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