24D2031434 CLIA NUMBER - WALGREENS #10501

Laboratory Demographics

  • CLIA Code: 24D2031434
  • Facility Name: WALGREENS #10501
  • Facility Address: 5474 MOUNTAIN IRON DR
    VIRGINIA, MN
    ZIP 55792
  • Facility Phone: 218 741-2421
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL B. ST MARTIN
  • NPI Number: 1396871489
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2031434
LAB Type Pharmacy
Facility Name WALGREENS #10501
Street 5474 MOUNTAIN IRON DR
City VIRGINIA
State MN
ZIP 55792
Phone 218 741-2421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director MICHAEL B. ST MARTIN

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