52D2176780 CLIA NUMBER - ASCENSION ALL SAINTS - MOUNT PLEASANT

Laboratory Demographics

CLIA Number: 52D2176780

Facility Name: ASCENSION ALL SAINTS - MOUNT PLEASANT

Facility Address:
10180 WASHINGTON AV
MOUNT PLEASANT, WI
ZIP 53177
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Facility Phone Number: 262 687-7528

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1851939037

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	52D2176780
LAB Type	Physician Office
Facility Name	ASCENSION ALL SAINTS - MOUNT PLEASANT
Street	10180 WASHINGTON AV
City	MOUNT PLEASANT
State	WI
ZIP	53177
Phone	262 687-7528
CertificateType	4
CertificateEffectiveDate	12/23/2023
CertificateExpirationDate	12/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024