24D2024529 CLIA NUMBER - WALGREENS 13690

Laboratory Demographics

  • CLIA Code: 24D2024529
  • Facility Name: WALGREENS 13690
  • Facility Address: 2099 FORD PKWY
    SAINT PAUL, MN
    ZIP 55116
  • Facility Phone: 651 414-3882
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WANGCHEN G. TAYTHI
  • NPI Number: 1831498989
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2024529
LAB Type Pharmacy
Facility Name WALGREENS 13690
Street 2099 FORD PKWY
City SAINT PAUL
State MN
ZIP 55116
Phone 651 414-3882
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director WANGCHEN G. TAYTHI

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