52D2220949 CLIA NUMBER - WALGREENS #05746

Laboratory Demographics

  • CLIA Code: 52D2220949
  • Facility Name: WALGREENS #05746
  • Facility Address: 1995 MAIN ST
    GREEN BAY, WI
    ZIP 54302
  • Facility Phone: 920 465-6210
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PA S. LEE
  • NPI Number: 1942215090
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2220949
LAB Type Pharmacy
Facility Name WALGREENS #05746
Street 1995 MAIN ST
City GREEN BAY
State WI
ZIP 54302
Phone 920 465-6210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director PA S. LEE

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