52D2183519 CLIA NUMBER - LIFE CHANGE PHARMACY 1

Laboratory Demographics

  • CLIA Code: 52D2183519
  • Facility Name: LIFE CHANGE PHARMACY 1
  • Facility Address: 1844 S 15TH ST
    MILWAUKEE, WI
    ZIP 53204
  • Facility Phone: 414 999-0999
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOHAMED EL SHEIKH
  • NPI Number: 1285278978
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2183519
LAB Type Pharmacy
Facility Name LIFE CHANGE PHARMACY 1
Street 1844 S 15TH ST
City MILWAUKEE
State WI
ZIP 53204
Phone 414 999-0999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2024
Certificate Expiration Date 5/5/2026
Facility Type Pharmacy
Lab Director MOHAMED EL SHEIKH

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