52D2209086 CLIA NUMBER - EVANSVILLE HOMETOWN PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2209086
  • Facility Name: EVANSVILLE HOMETOWN PHARMACY
  • Facility Address: 21 WEST MAIN ST
    EVANSVILLE, WI
    ZIP 53536
  • Facility Phone: 920 992-6800
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLA HOPP
  • NPI Number: 1598768137
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2209086
LAB Type Pharmacy
Facility Name EVANSVILLE HOMETOWN PHARMACY
Street 21 WEST MAIN ST
City EVANSVILLE
State WI
ZIP 53536
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 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Pharmacy
Lab Director NICOLA HOPP

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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