52D2125188 CLIA NUMBER - SUN PRAIRIE HOMETOWN PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2125188
  • Facility Name: SUN PRAIRIE HOMETOWN PHARMACY
  • Facility Address: 13 N BIRD STREET
    SUN PRAIRIE, WI
    ZIP 53590
  • Facility Phone: (608) 825-7530
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JASON BUENGER
  • NPI Number: 1316288152
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2125188
LAB Type Pharmacy
Facility Name SUN PRAIRIE HOMETOWN PHARMACY
Street 13 N BIRD STREET
City SUN PRAIRIE
State WI
ZIP 53590
Phone 6088257530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2025
Certificate Expiration Date 2/1/2027
Facility Type Pharmacy
Lab Director MR. JASON BUENGER

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This page was last updated on: 5/18/2026