52D2155866 CLIA NUMBER - COPPS FOOD CENTER PHARMACY #534-101

Laboratory Demographics

  • CLIA Code: 52D2155866
  • Facility Name: COPPS FOOD CENTER PHARMACY #534-101
  • Facility Address: 1850 PLOVER RD
    PLOVER, WI
    ZIP 54467
  • Facility Phone: 715 344-0066
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: BIRGITTA MONSON
  • NPI Number: 1548597545
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2155866
LAB Type Other - PHARMACY
Facility Name COPPS FOOD CENTER PHARMACY #534-101
Street 1850 PLOVER RD
City PLOVER
State WI
ZIP 54467
Phone 715 344-0066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Other - PHARMACY
Lab Director BIRGITTA MONSON

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