52D2217791 CLIA NUMBER - WALGREENS #11647

Laboratory Demographics

  • CLIA Code: 52D2217791
  • Facility Name: WALGREENS #11647
  • Facility Address: 717 8TH AVE
    MONROE, WI
    ZIP 53566
  • Facility Phone: 608 325-7020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ERIN KEVES
  • NPI Number: 1962661082
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2217791
LAB Type Pharmacy
Facility Name WALGREENS #11647
Street 717 8TH AVE
City MONROE
State WI
ZIP 53566
Phone 608 325-7020
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. ERIN KEVES

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