52D2273449 CLIA NUMBER - ALTSCRIPTS SPECIALTY PHARMACY

Laboratory Demographics

CLIA Number: 52D2273449

Facility Name: ALTSCRIPTS SPECIALTY PHARMACY

Facility Address:
1636 MILLER PARK WAY
WEST MILWAUKEE, WI
ZIP 53214
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Facility Phone Number: 414 385-9500

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1700268901

Taxonomy: 251F00000X - Home Infusion

CLIA Record

Field Name	Field Value
CLIA Number	52D2273449
LAB Type	Pharmacy
Facility Name	ALTSCRIPTS SPECIALTY PHARMACY
Street	1636 MILLER PARK WAY
City	WEST MILWAUKEE
State	WI
ZIP	53214
Phone	414 385-9500
CertificateType	4
CertificateEffectiveDate	12/13/2022
CertificateExpirationDate	12/12/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024