52D2217249 CLIA NUMBER - WALGREENS #03153

Laboratory Demographics

  • CLIA Code: 52D2217249
  • Facility Name: WALGREENS #03153
  • Facility Address: 3820 52ND ST
    KENOSHA, WI
    ZIP 53144
  • Facility Phone: 262 652-9665
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAWNY L. VOGEL
  • NPI Number: 1760497812
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2217249
LAB Type Pharmacy
Facility Name WALGREENS #03153
Street 3820 52ND ST
City KENOSHA
State WI
ZIP 53144
Phone 262 652-9665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director TAWNY L. VOGEL

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