52D2193752 CLIA NUMBER - TOMAHAWK PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2193752
  • Facility Name: TOMAHAWK PHARMACY
  • Facility Address: 315 W WISCONSIN AVE
    TOMAHAWK, WI
    ZIP 54487
  • Facility Phone: 715 453-6600
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. TYLER J. STEVENSON
  • NPI Number: 1285045377
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2193752
LAB Type Pharmacy
Facility Name TOMAHAWK PHARMACY
Street 315 W WISCONSIN AVE
City TOMAHAWK
State WI
ZIP 54487
Phone 715 453-6600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Pharmacy
Lab Director MR. TYLER J. STEVENSON

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