52D2221210 CLIA NUMBER - WALGREENS #07965

Laboratory Demographics

  • CLIA Code: 52D2221210
  • Facility Name: WALGREENS #07965
  • Facility Address: 7520 118TH AVE
    PLEASANT PRAIRIE, WI
    ZIP 53158
  • Facility Phone: 262 857-9484
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TEJAS R. DESAI
  • NPI Number: 1235144312
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2221210
LAB Type Pharmacy
Facility Name WALGREENS #07965
Street 7520 118TH AVE
City PLEASANT PRAIRIE
State WI
ZIP 53158
Phone 262 857-9484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Pharmacy
Lab Director TEJAS R. DESAI

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