52D2060896 CLIA NUMBER - WALGREENS #15188

Laboratory Demographics

  • CLIA Code: 52D2060896
  • Facility Name: WALGREENS #15188
  • Facility Address: 4035 N OAKLAND AVE
    SHOREWOOD, WI
    ZIP 53211
  • Facility Phone: 414 961-2001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. DONNELLY
  • NPI Number: 1376558262
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2060896
LAB Type Pharmacy
Facility Name WALGREENS #15188
Street 4035 N OAKLAND AVE
City SHOREWOOD
State WI
ZIP 53211
Phone 414 961-2001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Pharmacy
Lab Director MICHAEL J. DONNELLY

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