52D2239871 CLIA NUMBER - WALGREENS #09365

Laboratory Demographics

  • CLIA Code: 52D2239871
  • Facility Name: WALGREENS #09365
  • Facility Address: 423 MERTON AVE
    HARTLAND, WI
    ZIP 53029
  • Facility Phone: 262 367-4751
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW F. SENTKOWSKI
  • NPI Number: 1598770679
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2239871
LAB Type Pharmacy
Facility Name WALGREENS #09365
Street 423 MERTON AVE
City HARTLAND
State WI
ZIP 53029
Phone 262 367-4751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2023
Certificate Expiration Date 10/13/2025
Facility Type Pharmacy
Lab Director ANDREW F. SENTKOWSKI

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This page was last updated on: 6/4/2025