24D2011621 CLIA NUMBER - WALGREENS #06056

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Laboratory Demographics

CLIA Number: 24D2011621

Facility Name: WALGREENS #06056

Facility Address:
1965 DONEGAL DR
WOODBURY, MN
ZIP 55125
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Facility Phone Number: 651 735-0722

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205842846

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	24D2011621
LAB Type	Pharmacy
Facility Name	WALGREENS #06056
Street	1965 DONEGAL DR
City	WOODBURY
State	MN
ZIP	55125
Phone	651 735-0722
CertificateType	4
CertificateEffectiveDate	11/4/2023
CertificateExpirationDate	11/3/2025
FacilityType	Waiver

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