52D2058842 CLIA NUMBER - WALGREENS #03615

Laboratory Demographics

  • CLIA Code: 52D2058842
  • Facility Name: WALGREENS #03615
  • Facility Address: 21325 E MORELAND BLVD
    WAUKESHA, WI
    ZIP 53186
  • Facility Phone: 262 798-0223
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER JUGENHEIMER
  • NPI Number: 1023023173
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2058842
LAB Type Pharmacy
Facility Name WALGREENS #03615
Street 21325 E MORELAND BLVD
City WAUKESHA
State WI
ZIP 53186
Phone 262 798-0223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2023
Certificate Expiration Date 5/11/2025
Facility Type Pharmacy
Lab Director JENNIFER JUGENHEIMER

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This page was last updated on: 3/20/2025