52D2294006 CLIA NUMBER - WALGREENS 00665

Laboratory Demographics

  • CLIA Code: 52D2294006
  • Facility Name: WALGREENS 00665
  • Facility Address: 1600 W WISCONSIN AVE
    MILWAUKEE, WI
    ZIP 53233
  • Facility Phone: 414 344-1833
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACOB VANCE
  • NPI Number: 1831104728
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2294006
LAB Type Pharmacy
Facility Name WALGREENS 00665
Street 1600 W WISCONSIN AVE
City MILWAUKEE
State WI
ZIP 53233
Phone 414 344-1833
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Pharmacy
Lab Director JACOB VANCE

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