24D2031283 CLIA NUMBER - WALGREENS #12509

Laboratory Demographics

  • CLIA Code: 24D2031283
  • Facility Name: WALGREENS #12509
  • Facility Address: 700 30TH AVE S
    MOORHEAD, MN
    ZIP 56560
  • Facility Phone: 218 331-2668
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHANNING L. TURNER
  • NPI Number: 1235469826
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2031283
LAB Type Pharmacy
Facility Name WALGREENS #12509
Street 700 30TH AVE S
City MOORHEAD
State MN
ZIP 56560
Phone 218 331-2668
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director CHANNING L. TURNER

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