24D2007694 CLIA NUMBER - WALGREENS #10188

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Laboratory Demographics

CLIA Number: 24D2007694

Facility Name: WALGREENS #10188

Facility Address:
1615 QUEENS DR
WOODBURY, MN
ZIP 55125
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Facility Phone Number: 651 731-4778

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1376561308

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	24D2007694
LAB Type	Pharmacy
Facility Name	WALGREENS #10188
Street	1615 QUEENS DR
City	WOODBURY
State	MN
ZIP	55125
Phone	651 731-4778
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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