52D2116893 CLIA NUMBER - ST VINCENT DE PAUL CHARITABLE PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2116893
  • Facility Name: ST VINCENT DE PAUL CHARITABLE PHARMACY
  • Facility Address: 2033 FISH HATCHERY RD
    MADISON, WI
    ZIP 53725
  • Facility Phone: 608 268-0355
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. YOLANDA TOLSON
  • NPI Number: 1982943924
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2116893
LAB Type Pharmacy
Facility Name ST VINCENT DE PAUL CHARITABLE PHARMACY
Street 2033 FISH HATCHERY RD
City MADISON
State WI
ZIP 53725
Phone 608 268-0355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director MS. YOLANDA TOLSON

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This page was last updated on: 3/20/2025