52D2063714 CLIA NUMBER - EANNELLI PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2063714
  • Facility Name: EANNELLI PHARMACY
  • Facility Address: 405 WATER STREET
    PRAIRIE DU SAC, WI
    ZIP 53578
  • Facility Phone: 608 643-3396
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL A. EANNELLI
  • NPI Number: 1174534671
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2063714
LAB Type Pharmacy
Facility Name EANNELLI PHARMACY
Street 405 WATER STREET
City PRAIRIE DU SAC
State WI
ZIP 53578
Phone 608 643-3396
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Pharmacy
Lab Director MICHAEL A. EANNELLI

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