52D2215683 CLIA NUMBER - WALGREENS #07536

Laboratory Demographics

CLIA Number: 52D2215683

Facility Name: WALGREENS #07536

Facility Address:
8302 OLD SAUK ROAD
MIDDLETON, WI
ZIP 53562
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Facility Phone Number: 608 833-2373

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1427063502

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	52D2215683
LAB Type	Pharmacy
Facility Name	WALGREENS #07536
Street	8302 OLD SAUK ROAD
City	MIDDLETON
State	WI
ZIP	53562
Phone	608 833-2373
CertificateType	4
CertificateEffectiveDate	3/5/2023
CertificateExpirationDate	3/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024