52D2182658 CLIA NUMBER - OMRO PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2182658
  • Facility Name: OMRO PHARMACY
  • Facility Address: 328 EAST MAIN STREET
    OMRO, WI
    ZIP 54963
  • Facility Phone: 920 685-5041
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REID VAN GYSEL
  • NPI Number: 1275521528
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2182658
LAB Type Pharmacy
Facility Name OMRO PHARMACY
Street 328 EAST MAIN STREET
City OMRO
State WI
ZIP 54963
Phone 920 685-5041
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Pharmacy
Lab Director REID VAN GYSEL

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This page was last updated on: 6/4/2025