24D2011405 CLIA NUMBER - WALGREENS #00828

Laboratory Demographics

  • CLIA Code: 24D2011405
  • Facility Name: WALGREENS #00828
  • Facility Address: 12 WEST 66TH STREET
    RICHFIELD, MN
    ZIP 55423
  • Facility Phone: 612 861-7276
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOHAMED A. AW-DAHIR
  • NPI Number: 1508871815
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2011405
LAB Type Pharmacy
Facility Name WALGREENS #00828
Street 12 WEST 66TH STREET
City RICHFIELD
State MN
ZIP 55423
Phone 612 861-7276
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2023
Certificate Expiration Date 12/26/2025
Facility Type Pharmacy
Lab Director MOHAMED A. AW-DAHIR

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