52D2177192 CLIA NUMBER - MEIJER PHARMACY #304

Laboratory Demographics

  • CLIA Code: 52D2177192
  • Facility Name: MEIJER PHARMACY #304
  • Facility Address: 1818 S RAPIDS RD
    MANITOWOC, WI
    ZIP 54220
  • Facility Phone: 920 663-3845
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1104458140
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2177192
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #304
Street 1818 S RAPIDS RD
City MANITOWOC
State WI
ZIP 54220
Phone 920 663-3845
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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