52D2179424 CLIA NUMBER - FORWARD PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2179424
  • Facility Name: FORWARD PHARMACY
  • Facility Address: 429 W COTTAGE GROVE RD
    COTTAGE GROVE, WI
    ZIP 53527
  • Facility Phone: 608 839-3335
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. RYAN A. BENDER
  • NPI Number: 1053873521
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2179424
LAB Type Pharmacy
Facility Name FORWARD PHARMACY
Street 429 W COTTAGE GROVE RD
City COTTAGE GROVE
State WI
ZIP 53527
Phone 608 839-3335
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Pharmacy
Lab Director MR. RYAN A. BENDER

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