24D2007687 CLIA NUMBER - WALGREENS #01751

Laboratory Demographics

  • CLIA Code: 24D2007687
  • Facility Name: WALGREENS #01751
  • Facility Address: 2920 WHITE BEAR AVE N
    MAPLEWOOD, MN
    ZIP 55109
  • Facility Phone: 651 251-9938
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JODI PIDDE
  • NPI Number: 1457533143
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2007687
LAB Type Pharmacy
Facility Name WALGREENS #01751
Street 2920 WHITE BEAR AVE N
City MAPLEWOOD
State MN
ZIP 55109
Phone 651 251-9938
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Pharmacy
Lab Director JODI PIDDE

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