24D2022608 CLIA NUMBER - WALGREENS #13163

Laboratory Demographics

  • CLIA Code: 24D2022608
  • Facility Name: WALGREENS #13163
  • Facility Address: 18 SE 10TH ST
    GRAND RAPIDS, MN
    ZIP 55744
  • Facility Phone: 218 326-0069
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADRIAN R. COOK
  • NPI Number: 1992037105
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2022608
LAB Type Pharmacy
Facility Name WALGREENS #13163
Street 18 SE 10TH ST
City GRAND RAPIDS
State MN
ZIP 55744
Phone 218 326-0069
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Pharmacy
Lab Director ADRIAN R. COOK

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