52D2224131 CLIA NUMBER - WALGREENS #01988

Laboratory Demographics

  • CLIA Code: 52D2224131
  • Facility Name: WALGREENS #01988
  • Facility Address: 1915 WISCONSIN AVE
    GRAFTON, WI
    ZIP 53024
  • Facility Phone: 262 377-0352
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHILIP A. PARDA
  • NPI Number: 1245284272
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2224131
LAB Type Pharmacy
Facility Name WALGREENS #01988
Street 1915 WISCONSIN AVE
City GRAFTON
State WI
ZIP 53024
Phone 262 377-0352
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director PHILIP A. PARDA

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