52D2218930 CLIA NUMBER - WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #16301

Laboratory Demographics

CLIA Number: 52D2218930

Facility Name: WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #16301

Facility Address:
N95 W 17707 SHADY LN
MENOMONEE FALLS, WI
ZIP 53051
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1982742177

Taxonomy: 152W00000X - Optometrist
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

CLIA Record

Field Name	Field Value
CLIA Number	52D2218930
LAB Type	Pharmacy
Facility Name	WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #16301
Street	N95 W 17707 SHADY LN
City	MENOMONEE FALLS
State	WI
ZIP	53051
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	3/31/2023
CertificateExpirationDate	3/30/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024