52D2141756 CLIA NUMBER - WALGREENS #21396

Laboratory Demographics

  • CLIA Code: 52D2141756
  • Facility Name: WALGREENS #21396
  • Facility Address: 320 E CAPITOL DR
    MILWAUKEE, WI
    ZIP 53212
  • Facility Phone: 414 964-9851
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RANI DAHER
  • NPI Number: 1104833003
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2141756
LAB Type Pharmacy
Facility Name WALGREENS #21396
Street 320 E CAPITOL DR
City MILWAUKEE
State WI
ZIP 53212
Phone 414 964-9851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Pharmacy
Lab Director RANI DAHER

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This page was last updated on: 6/4/2025