52D2096928 CLIA NUMBER - MEIJER PHARMACY #277

Laboratory Demographics

  • CLIA Code: 52D2096928
  • Facility Name: MEIJER PHARMACY #277
  • Facility Address: 11111 W BURLEIGH ST
    WAUWATOSA, WI
    ZIP 53222
  • Facility Phone: 414 290-0910
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1093195596
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2096928
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #277
Street 11111 W BURLEIGH ST
City WAUWATOSA
State WI
ZIP 53222
Phone 414 290-0910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2025
Certificate Expiration Date 6/3/2027
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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