52D2280205 CLIA NUMBER - WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #05584

Laboratory Demographics

  • CLIA Code: 52D2280205
  • Facility Name: WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #05584
  • Facility Address: 6210 CENTURY AVE
    MIDDLETON, WI
    ZIP 53562
  • Facility Phone: 608 836-6630
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON CRAWFORD
  • NPI Number: 1548419278
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2280205
LAB Type Pharmacy
Facility Name WISCONSIN CVS PHARMACY, LLC DBA CVS/PHARMACY #05584
Street 6210 CENTURY AVE
City MIDDLETON
State WI
ZIP 53562
Phone 608 836-6630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Pharmacy
Lab Director JASON CRAWFORD

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