52D2053965 CLIA NUMBER - WALGREENS #05087

Laboratory Demographics

  • CLIA Code: 52D2053965
  • Facility Name: WALGREENS #05087
  • Facility Address: 2931 S FISH HATCHERY RD
    FITCHBURG, WI
    ZIP 53711
  • Facility Phone: 608 277-0087
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACOB P. JOHNSON
  • NPI Number: 1912914805
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2053965
LAB Type Pharmacy
Facility Name WALGREENS #05087
Street 2931 S FISH HATCHERY RD
City FITCHBURG
State WI
ZIP 53711
Phone 608 277-0087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director JACOB P. JOHNSON

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