24D1088677 CLIA NUMBER - THRIFTY WHITE DRUG PHARMACY #103

Laboratory Demographics

CLIA Number: 24D1088677

Facility Name: THRIFTY WHITE DRUG PHARMACY #103

Facility Address:
503 THIRD AVE E SUITE 100
ALEXANDRIA, MN
ZIP 56308
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Facility Phone Number: 320 762-1534

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1083056584

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D1088677
LAB Type	Pharmacy
Facility Name	THRIFTY WHITE DRUG PHARMACY #103
Street	503 THIRD AVE E SUITE 100
City	ALEXANDRIA
State	MN
ZIP	56308
Phone	320 762-1534
CertificateType	4
CertificateEffectiveDate	9/2/2022
CertificateExpirationDate	9/1/2024
FacilityType	Waiver

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