52D2142312 CLIA NUMBER - WALGREENS #12783

Laboratory Demographics

  • CLIA Code: 52D2142312
  • Facility Name: WALGREENS #12783
  • Facility Address: 2826 N MARTIN LUTHER KING DR
    MILWAUKEE, WI
    ZIP 53212
  • Facility Phone: 414 374-8536
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARAM QATOUNI
  • NPI Number: 1003821901
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2142312
LAB Type Pharmacy
Facility Name WALGREENS #12783
Street 2826 N MARTIN LUTHER KING DR
City MILWAUKEE
State WI
ZIP 53212
Phone 414 374-8536
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Pharmacy
Lab Director MARAM QATOUNI

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This page was last updated on: 3/20/2025