52D2217790 CLIA NUMBER - WALGREENS #11528

Laboratory Demographics

  • CLIA Code: 52D2217790
  • Facility Name: WALGREENS #11528
  • Facility Address: 1531 MADISON RD
    BELOIT, WI
    ZIP 53511
  • Facility Phone: 608 365-1904
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ANDREW M. WIEGEL
  • NPI Number: 1912173162
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2217790
LAB Type Pharmacy
Facility Name WALGREENS #11528
Street 1531 MADISON RD
City BELOIT
State WI
ZIP 53511
Phone 608 365-1904
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director DR. ANDREW M. WIEGEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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