52D2217558 CLIA NUMBER - WALGREENS #09166

Laboratory Demographics

  • CLIA Code: 52D2217558
  • Facility Name: WALGREENS #09166
  • Facility Address: 2206 WASHINGTON ST
    TWO RIVERS, WI
    ZIP 54241
  • Facility Phone: 920 793-8352
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. JAY URBAN
  • NPI Number: 1417962598
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2217558
LAB Type Pharmacy
Facility Name WALGREENS #09166
Street 2206 WASHINGTON ST
City TWO RIVERS
State WI
ZIP 54241
Phone 920 793-8352
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director DR. JAY URBAN

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