52D2287265 CLIA NUMBER - WALGREENS 02296

Laboratory Demographics

  • CLIA Code: 52D2287265
  • Facility Name: WALGREENS 02296
  • Facility Address: 2727 W NORTH AVE
    MILWAUKEE, WI
    ZIP 53208
  • Facility Phone: 414 933-9150
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYZONG S. PARK
  • NPI Number: 1851306906
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2287265
LAB Type Pharmacy
Facility Name WALGREENS 02296
Street 2727 W NORTH AVE
City MILWAUKEE
State WI
ZIP 53208
Phone 414 933-9150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Pharmacy
Lab Director KYZONG S. PARK

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