52D2185669 CLIA NUMBER - O'CONNELL PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2185669
  • Facility Name: O'CONNELL PHARMACY
  • Facility Address: 302 S GRAND AVE
    SUN PRAIRIE, WI
    ZIP 53590
  • Facility Phone: 608 837-5949
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. HOLLY C. ALTENBERGER
  • NPI Number: 1063781920
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2185669
LAB Type Pharmacy
Facility Name O'CONNELL PHARMACY
Street 302 S GRAND AVE
City SUN PRAIRIE
State WI
ZIP 53590
Phone 608 837-5949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2024
Certificate Expiration Date 6/7/2026
Facility Type Pharmacy
Lab Director MS. HOLLY C. ALTENBERGER

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