52D2217562 CLIA NUMBER - WALGREENS #06097

Laboratory Demographics

  • CLIA Code: 52D2217562
  • Facility Name: WALGREENS #06097
  • Facility Address: 3320 S BUSINESS DR
    SHEBOYGAN, WI
    ZIP 53081
  • Facility Phone: 920 452-5858
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ANDREW R. GROTE
  • NPI Number: 1538176417
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2217562
LAB Type Pharmacy
Facility Name WALGREENS #06097
Street 3320 S BUSINESS DR
City SHEBOYGAN
State WI
ZIP 53081
Phone 920 452-5858
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. ANDREW R. GROTE

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