24D2011621 CLIA NUMBER - WALGREENS #06056

Laboratory Demographics

  • CLIA Code: 24D2011621
  • Facility Name: WALGREENS #06056
  • Facility Address: 1965 DONEGAL DR
    WOODBURY, MN
    ZIP 55125
  • Facility Phone: 651 735-0722
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GREGG A. CARLTON
  • NPI Number: 1205842846
  • Taxonomy: 333600000X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Pharmacy
Lab Director GREGG A. CARLTON

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This page was last updated on: 6/4/2025