52D2196240 CLIA NUMBER - STEVENS POINT HOMETOWN PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 52D2196240
  • Facility Name: STEVENS POINT HOMETOWN PHARMACY LLC
  • Facility Address: 342A & 342B MAIN ST
    STEVENS POINT, WI
    ZIP 54481
  • Facility Phone: 920 992-6800
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TESSA GARR
  • NPI Number: 1992264667
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2196240
LAB Type Pharmacy
Facility Name STEVENS POINT HOMETOWN PHARMACY LLC
Street 342A & 342B MAIN ST
City STEVENS POINT
State WI
ZIP 54481
Phone 920 992-6800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2024
Certificate Expiration Date 10/14/2026
Facility Type Pharmacy
Lab Director TESSA GARR

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