52D2223054 CLIA NUMBER - WALGREENS #12020

Laboratory Demographics

  • CLIA Code: 52D2223054
  • Facility Name: WALGREENS #12020
  • Facility Address: 2702 CALUMET DR
    SHEBOYGAN, WI
    ZIP 53083
  • Facility Phone: 920 457-5656
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH S. HIGGINS
  • NPI Number: 1093720997
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2223054
LAB Type Pharmacy
Facility Name WALGREENS #12020
Street 2702 CALUMET DR
City SHEBOYGAN
State WI
ZIP 53083
Phone 920 457-5656
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director JOSEPH S. HIGGINS

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