24D2035805 CLIA NUMBER - WALGREENS #10210

Laboratory Demographics

  • CLIA Code: 24D2035805
  • Facility Name: WALGREENS #10210
  • Facility Address: 1100 2ND ST S
    SARTELL, MN
    ZIP 56377
  • Facility Phone: 320 654-8542
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHELBY MALMANGER
  • NPI Number: 1568477792
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2035805
LAB Type Pharmacy
Facility Name WALGREENS #10210
Street 1100 2ND ST S
City SARTELL
State MN
ZIP 56377
Phone 320 654-8542
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Pharmacy
Lab Director SHELBY MALMANGER

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