52D2163997 CLIA NUMBER - WINNECONNE HOMETOWN PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2163997
  • Facility Name: WINNECONNE HOMETOWN PHARMACY
  • Facility Address: 911 E MAIN ST
    WINNECONNE, WI
    ZIP 54986
  • Facility Phone: 920 706-0720
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUDITH DUDEK
  • NPI Number: 1972060853
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2163997
LAB Type Pharmacy
Facility Name WINNECONNE HOMETOWN PHARMACY
Street 911 E MAIN ST
City WINNECONNE
State WI
ZIP 54986
Phone 920 706-0720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director JUDITH DUDEK

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