52D2111816 CLIA NUMBER - CHET JOHNSON DRUG INC

Laboratory Demographics

  • CLIA Code: 52D2111816
  • Facility Name: CHET JOHNSON DRUG INC
  • Facility Address: 204 KELLER AVE
    AMERY, WI
    ZIP 54001
  • Facility Phone: 715 268-8121
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. MATTHEW JOHNSON
  • NPI Number: 1184711087
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2111816
LAB Type Pharmacy
Facility Name CHET JOHNSON DRUG INC
Street 204 KELLER AVE
City AMERY
State WI
ZIP 54001
Phone 715 268-8121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2024
Certificate Expiration Date 4/14/2026
Facility Type Pharmacy
Lab Director MR. MATTHEW JOHNSON

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