52D2232137 CLIA NUMBER - WALGREENS #04827

Laboratory Demographics

  • CLIA Code: 52D2232137
  • Facility Name: WALGREENS #04827
  • Facility Address: 4688 S 108TH ST
    GREENFIELD, WI
    ZIP 53228
  • Facility Phone: 414 427-1328
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW J. PETRUS
  • NPI Number: 1811902976
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2232137
LAB Type Pharmacy
Facility Name WALGREENS #04827
Street 4688 S 108TH ST
City GREENFIELD
State WI
ZIP 53228
Phone 414 427-1328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director MATTHEW J. PETRUS

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