52D2059520 CLIA NUMBER - WALGREENS #09740

Laboratory Demographics

  • CLIA Code: 52D2059520
  • Facility Name: WALGREENS #09740
  • Facility Address: 807 S MAIN ST
    DE FOREST, WI
    ZIP 53532
  • Facility Phone: 608 846-3671
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. MICHAEL F. CROMBIE
  • NPI Number: 1871508952
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2059520
LAB Type Pharmacy
Facility Name WALGREENS #09740
Street 807 S MAIN ST
City DE FOREST
State WI
ZIP 53532
Phone 608 846-3671
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director MR. MICHAEL F. CROMBIE

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