52D2287943 CLIA NUMBER - WALGREENS 05636

Laboratory Demographics

  • CLIA Code: 52D2287943
  • Facility Name: WALGREENS 05636
  • Facility Address: 230 MADISON ST
    WAUKESHA, WI
    ZIP 53188
  • Facility Phone: 262 542-9935
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BORIS KATICIC
  • NPI Number: 1891702775
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2287943
LAB Type Pharmacy
Facility Name WALGREENS 05636
Street 230 MADISON ST
City WAUKESHA
State WI
ZIP 53188
Phone 262 542-9935
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Pharmacy
Lab Director BORIS KATICIC

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