52D2225284 CLIA NUMBER - WALGREENS #02879

Laboratory Demographics

  • CLIA Code: 52D2225284
  • Facility Name: WALGREENS #02879
  • Facility Address: 2121 S PARK ST
    MADISON, WI
    ZIP 53713
  • Facility Phone: 608 257-0804
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SYDNEY C. SCHUMITSCH-JEWELL
  • NPI Number: 1013922913
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2225284
LAB Type Pharmacy
Facility Name WALGREENS #02879
Street 2121 S PARK ST
City MADISON
State WI
ZIP 53713
Phone 608 257-0804
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Pharmacy
Lab Director SYDNEY C. SCHUMITSCH-JEWELL

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