52D2207138 CLIA NUMBER - WALGREENS #10963

Laboratory Demographics

  • CLIA Code: 52D2207138
  • Facility Name: WALGREENS #10963
  • Facility Address: 6101 W GREENFIELD AVE
    WEST ALLIS, WI
    ZIP 53214
  • Facility Phone: 414 258-1652
  • Facility Type: Other - COVID TESTING
  • Facility Type: Waiver
  • Lab Director: MS. JESSICA MAYER
  • NPI Number: 1316193618
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2207138
LAB Type Other - COVID TESTING
Facility Name WALGREENS #10963
Street 6101 W GREENFIELD AVE
City WEST ALLIS
State WI
ZIP 53214
Phone 414 258-1652
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2024
Certificate Expiration Date 12/22/2026
Facility Type Other - COVID TESTING
Lab Director MS. JESSICA MAYER

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