24D2034840 CLIA NUMBER - WALGREENS #09350

Laboratory Demographics

  • CLIA Code: 24D2034840
  • Facility Name: WALGREENS #09350
  • Facility Address: 1123 E BLUE EARTH AVE
    FAIRMONT, MN
    ZIP 56031
  • Facility Phone: 507 235-5965
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA M. SEIBERT
  • NPI Number: 1831104066
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2034840
LAB Type Pharmacy
Facility Name WALGREENS #09350
Street 1123 E BLUE EARTH AVE
City FAIRMONT
State MN
ZIP 56031
Phone 507 235-5965
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director AMANDA M. SEIBERT

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