52D2224257 CLIA NUMBER - WALGREENS #12456

Laboratory Demographics

  • CLIA Code: 52D2224257
  • Facility Name: WALGREENS #12456
  • Facility Address: 4415 STATE ROAD 16
    LA CROSSE, WI
    ZIP 54601
  • Facility Phone: 608 779-0939
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN R. ANDEREGG
  • NPI Number: 1790087427
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2224257
LAB Type Pharmacy
Facility Name WALGREENS #12456
Street 4415 STATE ROAD 16
City LA CROSSE
State WI
ZIP 54601
Phone 608 779-0939
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 RYAN R. ANDEREGG

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