24D2044782 CLIA NUMBER - THRIFTY WHITE PHARMACY #769

Laboratory Demographics

  • CLIA Code: 24D2044782
  • Facility Name: THRIFTY WHITE PHARMACY #769
  • Facility Address: 2409 HANNAH AVE NW
    BEMIDJI, MN
    ZIP 56601
  • Facility Phone: 218 751-6380
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JORDAN WESTRUM
  • NPI Number: 1720253479
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2044782
LAB Type Pharmacy
Facility Name THRIFTY WHITE PHARMACY #769
Street 2409 HANNAH AVE NW
City BEMIDJI
State MN
ZIP 56601
Phone 218 751-6380
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Pharmacy
Lab Director JORDAN WESTRUM

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