24D2054828 CLIA NUMBER - THRIFTY WHITE PHARMACY #754

Laboratory Demographics

  • CLIA Code: 24D2054828
  • Facility Name: THRIFTY WHITE PHARMACY #754
  • Facility Address: 60 ARROWHEAD LANE
    MOOSE LAKE, MN
    ZIP 55767
  • Facility Phone: 218 485-4401
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SETH GOLDEN
  • NPI Number: 1598855439
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2054828
LAB Type Pharmacy
Facility Name THRIFTY WHITE PHARMACY #754
Street 60 ARROWHEAD LANE
City MOOSE LAKE
State MN
ZIP 55767
Phone 218 485-4401
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 SETH GOLDEN

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