52D2051453 CLIA NUMBER - WALGREENS #04774

Laboratory Demographics

  • CLIA Code: 52D2051453
  • Facility Name: WALGREENS #04774
  • Facility Address: 8333 W GREENFIELD AVE
    WEST ALLIS, WI
    ZIP 53214
  • Facility Phone: 414 443-9414
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE JERSTAD
  • NPI Number: 1013924059
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2051453
LAB Type Pharmacy
Facility Name WALGREENS #04774
Street 8333 W GREENFIELD AVE
City WEST ALLIS
State WI
ZIP 53214
Phone 414 443-9414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2025
Certificate Expiration Date 10/12/2027
Facility Type Pharmacy
Lab Director STEPHANIE JERSTAD

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