52D2043681 CLIA NUMBER - WALGREENS #06096

Laboratory Demographics

  • CLIA Code: 52D2043681
  • Facility Name: WALGREENS #06096
  • Facility Address: 1901 PRAIRIE AVE
    BELOIT, WI
    ZIP 53511
  • Facility Phone: 608 365-2001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JALEN MCMARTIN
  • NPI Number: 1396908935
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2043681
LAB Type Pharmacy
Facility Name WALGREENS #06096
Street 1901 PRAIRIE AVE
City BELOIT
State WI
ZIP 53511
Phone 608 365-2001
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 JALEN MCMARTIN

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