52D2258977 CLIA NUMBER - WISCONSIN CVS PHARMACY, LLC DBA CV/PHARMACY #02237

Laboratory Demographics

  • CLIA Code: 52D2258977
  • Facility Name: WISCONSIN CVS PHARMACY, LLC DBA CV/PHARMACY #02237
  • Facility Address: 930 MAIN ST
    GREEN BAY, WI
    ZIP 54301
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SETH WIERSMA
  • NPI Number: 1306134655
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258977
LAB Type Pharmacy
Facility Name WISCONSIN CVS PHARMACY, LLC DBA CV/PHARMACY #02237
Street 930 MAIN ST
City GREEN BAY
State WI
ZIP 54301
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 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Pharmacy
Lab Director SETH WIERSMA

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