52D2050007 CLIA NUMBER - WALGREENS #02110

Laboratory Demographics

  • CLIA Code: 52D2050007
  • Facility Name: WALGREENS #02110
  • Facility Address: 829 E GREEN BAY AVE
    SAUKVILLE, WI
    ZIP 53080
  • Facility Phone: 262 268-9091
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN J. KESLER
  • NPI Number: 1063427144
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2050007
LAB Type Pharmacy
Facility Name WALGREENS #02110
Street 829 E GREEN BAY AVE
City SAUKVILLE
State WI
ZIP 53080
Phone 262 268-9091
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Pharmacy
Lab Director RYAN J. KESLER

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