52D2209914 CLIA NUMBER - WILZ DRUG INC

Laboratory Demographics

  • CLIA Code: 52D2209914
  • Facility Name: WILZ DRUG INC
  • Facility Address: 140 EAST COOK ST
    PORTAGE, WI
    ZIP 53901
  • Facility Phone: 920 992-6800
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAWRENCE CROWLEY
  • NPI Number: 1548285398
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2209914
LAB Type Pharmacy
Facility Name WILZ DRUG INC
Street 140 EAST COOK ST
City PORTAGE
State WI
ZIP 53901
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 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Pharmacy
Lab Director LAWRENCE CROWLEY

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