52D2063717 CLIA NUMBER - WALGREENS #11236

Laboratory Demographics

  • CLIA Code: 52D2063717
  • Facility Name: WALGREENS #11236
  • Facility Address: 2519 KETTERING ST
    JANESVILLE, WI
    ZIP 53546
  • Facility Phone: 608 754-0007
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL W. GENET
  • NPI Number: 1528225422
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2063717
LAB Type Pharmacy
Facility Name WALGREENS #11236
Street 2519 KETTERING ST
City JANESVILLE
State WI
ZIP 53546
Phone 608 754-0007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director MICHAEL W. GENET

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