24D2007696 CLIA NUMBER - WALGREENS #11250

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Laboratory Demographics

CLIA Number: 24D2007696

Facility Name: WALGREENS #11250

Facility Address:
3913 W OLD SHAKOPEE RD
BLOOMINGTON, MN
ZIP 55437
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Facility Phone Number: 952 252-1062

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1841424926

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	24D2007696
LAB Type	Pharmacy
Facility Name	WALGREENS #11250
Street	3913 W OLD SHAKOPEE RD
City	BLOOMINGTON
State	MN
ZIP	55437
Phone	952 252-1062
CertificateType	4
CertificateEffectiveDate	4/23/2023
CertificateExpirationDate	4/22/2025
FacilityType	Waiver

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