52D2217250 CLIA NUMBER - WALGREEN #03022

Laboratory Demographics

  • CLIA Code: 52D2217250
  • Facility Name: WALGREEN #03022
  • Facility Address: 819 N MEMORIAL DR
    RACINE, WI
    ZIP 53404
  • Facility Phone: 262 637-4900
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LOREWELL BUAYA
  • NPI Number: 1740295633
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2217250
LAB Type Pharmacy
Facility Name WALGREEN #03022
Street 819 N MEMORIAL DR
City RACINE
State WI
ZIP 53404
Phone 262 637-4900
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 LOREWELL BUAYA

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