52D2279467 CLIA NUMBER - WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #08541

Laboratory Demographics

  • CLIA Code: 52D2279467
  • Facility Name: WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #08541
  • Facility Address: 1561 W MASON ST
    GREEN BAY, WI
    ZIP 54303
  • Facility Phone: 920 497-5959
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIELLE KRAAK
  • NPI Number: 1447291315
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2279467
LAB Type Pharmacy
Facility Name WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #08541
Street 1561 W MASON ST
City GREEN BAY
State WI
ZIP 54303
Phone 920 497-5959
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Pharmacy
Lab Director DANIELLE KRAAK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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