24D0966599 CLIA NUMBER - WALGREENS #02769

Laboratory Demographics

  • CLIA Code: 24D0966599
  • Facility Name: WALGREENS #02769
  • Facility Address: 915 WILDWOOD RD
    WHITE BEAR LAKE, MN
    ZIP 55115
  • Facility Phone: 651 426-7333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN D. HILLEGASS
  • NPI Number: 1033124359
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D0966599
LAB Type Pharmacy
Facility Name WALGREENS #02769
Street 915 WILDWOOD RD
City WHITE BEAR LAKE
State MN
ZIP 55115
Phone 651 426-7333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Pharmacy
Lab Director KEVIN D. HILLEGASS

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