24D2054836 CLIA NUMBER - THRIFTY WHITE #774

Laboratory Demographics

  • CLIA Code: 24D2054836
  • Facility Name: THRIFTY WHITE #774
  • Facility Address: 2622 BROADWAY AVENUE
    SLAYTON, MN
    ZIP 56172
  • Facility Phone: 507 836-6702
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MACI HAZELTON
  • NPI Number: 1376783225
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2054836
LAB Type Pharmacy
Facility Name THRIFTY WHITE #774
Street 2622 BROADWAY AVENUE
City SLAYTON
State MN
ZIP 56172
Phone 507 836-6702
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 MACI HAZELTON

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