52D2287449 CLIA NUMBER - WALGREENS 09514

Laboratory Demographics

CLIA Number: 52D2287449

Facility Name: WALGREENS 09514

Facility Address:
121 PINE AVE W
MENOMONIE, WI
ZIP 54751
Get Directions

Facility Phone Number: 715 235-9275

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1962417048

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	52D2287449
LAB Type	Pharmacy
Facility Name	WALGREENS 09514
Street	121 PINE AVE W
City	MENOMONIE
State	WI
ZIP	54751
Phone	715 235-9275
CertificateType	4
CertificateEffectiveDate	8/15/2023
CertificateExpirationDate	8/14/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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