24D2011404 CLIA NUMBER - WALGREENS 03114

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Laboratory Demographics

CLIA Number: 24D2011404

Facility Name: WALGREENS 03114

Facility Address:
6975 YORK AVE S
EDINA, MN
ZIP 55435
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Facility Phone Number: 952 920-3561

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205841525

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	24D2011404
LAB Type	Pharmacy
Facility Name	WALGREENS 03114
Street	6975 YORK AVE S
City	EDINA
State	MN
ZIP	55435
Phone	952 920-3561
CertificateType	4
CertificateEffectiveDate	8/22/2023
CertificateExpirationDate	8/21/2025
FacilityType	Waiver

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