24D2011176 CLIA NUMBER - WALGREENS #07290

Laboratory Demographics

  • CLIA Code: 24D2011176
  • Facility Name: WALGREENS #07290
  • Facility Address: 1270 MADISON AVE
    MANKATO, MN
    ZIP 56001
  • Facility Phone: 507 388-1315
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT STICKEL
  • NPI Number: 1972518280
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2011176
LAB Type Pharmacy
Facility Name WALGREENS #07290
Street 1270 MADISON AVE
City MANKATO
State MN
ZIP 56001
Phone 507 388-1315
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Pharmacy
Lab Director ROBERT STICKEL

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