52D2128351 CLIA NUMBER - PARDEEVILLE HOMETOWN PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2128351
  • Facility Name: PARDEEVILLE HOMETOWN PHARMACY
  • Facility Address: 117 NORTH MAIN STREET
    PARDEEVILLE, WI
    ZIP 53954
  • Facility Phone: 608 429-2325
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH SCHAEFER
  • NPI Number: 1043480296
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2128351
LAB Type Pharmacy
Facility Name PARDEEVILLE HOMETOWN PHARMACY
Street 117 NORTH MAIN STREET
City PARDEEVILLE
State WI
ZIP 53954
Phone 608 429-2325
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 KENNETH SCHAEFER

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