52D2239909 CLIA NUMBER - WALGREENS #12019

Laboratory Demographics

  • CLIA Code: 52D2239909
  • Facility Name: WALGREENS #12019
  • Facility Address: 2803 N MEADE ST
    APPLETON, WI
    ZIP 54911
  • Facility Phone: 920 830-6985
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN TERESINSKI
  • NPI Number: 1851529101
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2239909
LAB Type Pharmacy
Facility Name WALGREENS #12019
Street 2803 N MEADE ST
City APPLETON
State WI
ZIP 54911
Phone 920 830-6985
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2025
Certificate Expiration Date 10/13/2027
Facility Type Pharmacy
Lab Director BRIAN TERESINSKI

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