24D2031291 CLIA NUMBER - WALGREENS 11157

Laboratory Demographics

  • CLIA Code: 24D2031291
  • Facility Name: WALGREENS 11157
  • Facility Address: 910 BROADWAY ST
    ALEXANDRIA, MN
    ZIP 56308
  • Facility Phone: 320 763-4360
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE L. KETELSEN
  • NPI Number: 1033394671
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2031291
LAB Type Pharmacy
Facility Name WALGREENS 11157
Street 910 BROADWAY ST
City ALEXANDRIA
State MN
ZIP 56308
Phone 320 763-4360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Pharmacy
Lab Director NICOLE L. KETELSEN

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