52D2287215 CLIA NUMBER - WALGREENS 09008

Laboratory Demographics

  • CLIA Code: 52D2287215
  • Facility Name: WALGREENS 09008
  • Facility Address: 403 GATEWAY AVE
    MAUSTON, WI
    ZIP 53948
  • Facility Phone: 608 847-7814
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEVON M. PENN
  • NPI Number: 1285649186
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2287215
LAB Type Pharmacy
Facility Name WALGREENS 09008
Street 403 GATEWAY AVE
City MAUSTON
State WI
ZIP 53948
Phone 608 847-7814
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director DEVON M. PENN

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