52D2185076 CLIA NUMBER - SAGE SPECIALTY PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2185076
  • Facility Name: SAGE SPECIALTY PHARMACY
  • Facility Address: 4001 N OAKLAND AVE
    SHOREWOOD, WI
    ZIP 53211
  • Facility Phone: 414 861-7243
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JON S. PHILLIPS
  • NPI Number: 1710527783
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2185076
LAB Type Pharmacy
Facility Name SAGE SPECIALTY PHARMACY
Street 4001 N OAKLAND AVE
City SHOREWOOD
State WI
ZIP 53211
Phone 414 861-7243
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Pharmacy
Lab Director MR. JON S. PHILLIPS

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