52D2240158 CLIA NUMBER - WALGREENS #01976

Laboratory Demographics

  • CLIA Code: 52D2240158
  • Facility Name: WALGREENS #01976
  • Facility Address: 300 N MAIN ST
    FORT ATKINSON, WI
    ZIP 53538
  • Facility Phone: 920 568-9326
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERICA I. THOMPSON
  • NPI Number: 1780699868
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2240158
LAB Type Pharmacy
Facility Name WALGREENS #01976
Street 300 N MAIN ST
City FORT ATKINSON
State WI
ZIP 53538
Phone 920 568-9326
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Pharmacy
Lab Director ERICA I. THOMPSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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