52D2225583 CLIA NUMBER - WALGREENS #07732

Laboratory Demographics

  • CLIA Code: 52D2225583
  • Facility Name: WALGREENS #07732
  • Facility Address: 2700 NEW PINERY RD
    PORTAGE, WI
    ZIP 53901
  • Facility Phone: 608 742-5727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID R. JACOBSON
  • NPI Number: 1962417014
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2225583
LAB Type Pharmacy
Facility Name WALGREENS #07732
Street 2700 NEW PINERY RD
City PORTAGE
State WI
ZIP 53901
Phone 608 742-5727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Pharmacy
Lab Director DAVID R. JACOBSON

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