52D2217844 CLIA NUMBER - WALGREENS #07143

Laboratory Demographics

  • CLIA Code: 52D2217844
  • Facility Name: WALGREENS #07143
  • Facility Address: N56W15501 SPRING DR
    MENOMONEE FALLS, WI
    ZIP 53051
  • Facility Phone: 262 703-9781
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY BAKIC
  • NPI Number: 1083629158
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2217844
LAB Type Pharmacy
Facility Name WALGREENS #07143
Street N56W15501 SPRING DR
City MENOMONEE FALLS
State WI
ZIP 53051
Phone 262 703-9781
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 KELLY BAKIC

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