52D2288395 CLIA NUMBER - WALGREENS 02752

Laboratory Demographics

  • CLIA Code: 52D2288395
  • Facility Name: WALGREENS 02752
  • Facility Address: 15350 W BLUEMOUND RD
    ELM GROVE, WI
    ZIP 53122
  • Facility Phone: 262 789-6819
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE L. POLIQUIN
  • NPI Number: 1316952468
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2288395
LAB Type Pharmacy
Facility Name WALGREENS 02752
Street 15350 W BLUEMOUND RD
City ELM GROVE
State WI
ZIP 53122
Phone 262 789-6819
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Pharmacy
Lab Director STEPHANIE L. POLIQUIN

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