24D2012495 CLIA NUMBER - WALGREENS #02805

Laboratory Demographics

  • CLIA Code: 24D2012495
  • Facility Name: WALGREENS #02805
  • Facility Address: 1133 ROBERT ST S
    WEST SAINT PAUL, MN
    ZIP 55118
  • Facility Phone: 651 455-5590
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIAN D. BLOOMQUIST
  • NPI Number: 1134134448
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2012495
LAB Type Pharmacy
Facility Name WALGREENS #02805
Street 1133 ROBERT ST S
City WEST SAINT PAUL
State MN
ZIP 55118
Phone 651 455-5590
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 KRISTIAN D. BLOOMQUIST

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