52D2213206 CLIA NUMBER - WALGREENS #13620

Laboratory Demographics

  • CLIA Code: 52D2213206
  • Facility Name: WALGREENS #13620
  • Facility Address: W62 N190 WASHINGTON AVE
    CEDARBURG, WI
    ZIP 53012
  • Facility Phone: 262 375-3039
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH GERHARDT JR
  • NPI Number: 1730194630
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2213206
LAB Type Pharmacy
Facility Name WALGREENS #13620
Street W62 N190 WASHINGTON AVE
City CEDARBURG
State WI
ZIP 53012
Phone 262 375-3039
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Pharmacy
Lab Director KENNETH GERHARDT JR

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