24D2055064 CLIA NUMBER - WALGREENS #12535

Laboratory Demographics

  • CLIA Code: 24D2055064
  • Facility Name: WALGREENS #12535
  • Facility Address: 1705 COMMERCE DR
    NORTH MANKATO, MN
    ZIP 56003
  • Facility Phone: 507 388-1617
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANDRA J. EINEKE
  • NPI Number: 1881850170
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2055064
LAB Type Pharmacy
Facility Name WALGREENS #12535
Street 1705 COMMERCE DR
City NORTH MANKATO
State MN
ZIP 56003
Phone 507 388-1617
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Pharmacy
Lab Director SANDRA J. EINEKE

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This page was last updated on: 3/20/2025