52D2269303 CLIA NUMBER - EDS PHARMACY

Laboratory Demographics

  • CLIA Code: 52D2269303
  • Facility Name: EDS PHARMACY
  • Facility Address: 1511 MAIN ST
    BLOOMER, WI
    ZIP 54724
  • Facility Phone: 715 568-2190
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATIE WOLLUM
  • NPI Number: 1184726077
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2269303
LAB Type Pharmacy
Facility Name EDS PHARMACY
Street 1511 MAIN ST
City BLOOMER
State WI
ZIP 54724
Phone 715 568-2190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Pharmacy
Lab Director KATIE WOLLUM

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