52D2095206 CLIA NUMBER - MEIJER PHARMACY #274

Laboratory Demographics

  • CLIA Code: 52D2095206
  • Facility Name: MEIJER PHARMACY #274
  • Facility Address: 1600 PORT WASHINGTON RD
    GRAFTON, WI
    ZIP 53024
  • Facility Phone: 262 204-2810
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1730574864
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2095206
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #274
Street 1600 PORT WASHINGTON RD
City GRAFTON
State WI
ZIP 53024
Phone 262 204-2810
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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