52D2126972 CLIA NUMBER - MEIJER PHARMACY #299

Laboratory Demographics

  • CLIA Code: 52D2126972
  • Facility Name: MEIJER PHARMACY #299
  • Facility Address: 2180 SOUTH MAIN STREET
    WEST BEND, WI
    ZIP 53095
  • Facility Phone: 262 334-8510
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1396280160
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2126972
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #299
Street 2180 SOUTH MAIN STREET
City WEST BEND
State WI
ZIP 53095
Phone 262 334-8510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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