52D2257579 CLIA NUMBER - WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #10143

Laboratory Demographics

  • CLIA Code: 52D2257579
  • Facility Name: WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #10143
  • Facility Address: 1700 MILTON AVE
    JANESVILLE, WI
    ZIP 53545
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELISSA MASSOGLIA
  • NPI Number: 1548308745
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 52D2257579
LAB Type Pharmacy
Facility Name WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #10143
Street 1700 MILTON AVE
City JANESVILLE
State WI
ZIP 53545
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Pharmacy
Lab Director MELISSA MASSOGLIA

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