52D2125748 CLIA NUMBER - LODI HOMETOWN PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2125748
  • Facility Name: LODI HOMETOWN PHARMACY
  • Facility Address: 801 N MAIN ST
    LODI, WI
    ZIP 53555
  • Facility Phone: 608 592-0662
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIELLE YOUNG
  • NPI Number: 1144770553
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2125748
LAB Type Pharmacy
Facility Name LODI HOMETOWN PHARMACY
Street 801 N MAIN ST
City LODI
State WI
ZIP 53555
Phone 608 592-0662
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Pharmacy
Lab Director DANIELLE YOUNG

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