24D2031268 CLIA NUMBER - WALGREENS #10187

Laboratory Demographics

  • CLIA Code: 24D2031268
  • Facility Name: WALGREENS #10187
  • Facility Address: 900 MAIN AVE
    MOORHEAD, MN
    ZIP 56560
  • Facility Phone: 218 236-0252
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HEALTH P. WASNESS
  • NPI Number: 1962415091
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2031268
LAB Type Pharmacy
Facility Name WALGREENS #10187
Street 900 MAIN AVE
City MOORHEAD
State MN
ZIP 56560
Phone 218 236-0252
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Pharmacy
Lab Director HEALTH P. WASNESS

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