52D2217912 CLIA NUMBER - WALGREENS #07730

Laboratory Demographics

  • CLIA Code: 52D2217912
  • Facility Name: WALGREENS #07730
  • Facility Address: 2700 N GRANDVIEW BLVD
    WAUKESHA, WI
    ZIP 53188
  • Facility Phone: 262 542-2003
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SCOTT WILCOX
  • NPI Number: 1417964305
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2217912
LAB Type Pharmacy
Facility Name WALGREENS #07730
Street 2700 N GRANDVIEW BLVD
City WAUKESHA
State WI
ZIP 53188
Phone 262 542-2003
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 SCOTT WILCOX

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This page was last updated on: 6/4/2025