52D2268868 CLIA NUMBER - MEDICINE SHOPPE PHARMACY 0605, LTD

Laboratory Demographics

  • CLIA Code: 52D2268868
  • Facility Name: MEDICINE SHOPPE PHARMACY 0605, LTD
  • Facility Address: 4205 MONONA DR
    MONONA, WI
    ZIP 53716
  • Facility Phone: 608 221-8151
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC C. HEWITT
  • NPI Number: 1841302767
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2268868
LAB Type Pharmacy
Facility Name MEDICINE SHOPPE PHARMACY 0605, LTD
Street 4205 MONONA DR
City MONONA
State WI
ZIP 53716
Phone 608 221-8151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Pharmacy
Lab Director ERIC C. HEWITT

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