24D2011400 CLIA NUMBER - WALGREENS #06280

Laboratory Demographics

  • CLIA Code: 24D2011400
  • Facility Name: WALGREENS #06280
  • Facility Address: 16395 WAGNER WAY
    EDEN PRAIRIE, MN
    ZIP 55344
  • Facility Phone: 952 937-2934
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DARREN N. FICK
  • NPI Number: 1396750618
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2011400
LAB Type Pharmacy
Facility Name WALGREENS #06280
Street 16395 WAGNER WAY
City EDEN PRAIRIE
State MN
ZIP 55344
Phone 952 937-2934
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Pharmacy
Lab Director DARREN N. FICK

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