24D2054821 CLIA NUMBER - THRIFTY WHITE #758

Laboratory Demographics

  • CLIA Code: 24D2054821
  • Facility Name: THRIFTY WHITE #758
  • Facility Address: 18 SOUTH MARSHALL AVENUE
    SPRINGFIELD, MN
    ZIP 56087
  • Facility Phone: (507) 723-4313
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACOB MARZ
  • NPI Number: 1134218746
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2054821
LAB Type Pharmacy
Facility Name THRIFTY WHITE #758
Street 18 SOUTH MARSHALL AVENUE
City SPRINGFIELD
State MN
ZIP 56087
Phone 5077234313
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Pharmacy
Lab Director JACOB MARZ

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This page was last updated on: 6/29/2026