24D2011622 CLIA NUMBER - WALGREENS 02661

Laboratory Demographics

  • CLIA Code: 24D2011622
  • Facility Name: WALGREENS 02661
  • Facility Address: 15250 CEDAR AVE
    APPLE VALLEY, MN
    ZIP 55124
  • Facility Phone: 952 432-5557
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADY D. PETERSON
  • NPI Number: 1942215264
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2011622
LAB Type Pharmacy
Facility Name WALGREENS 02661
Street 15250 CEDAR AVE
City APPLE VALLEY
State MN
ZIP 55124
Phone 952 432-5557
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2025
Certificate Expiration Date 10/8/2027
Facility Type Pharmacy
Lab Director BRADY D. PETERSON

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