24D2055074 CLIA NUMBER - WALGREENS #07218

Laboratory Demographics

  • CLIA Code: 24D2055074
  • Facility Name: WALGREENS #07218
  • Facility Address: 12480 ABERDEEN ST NE
    BLAINE, MN
    ZIP 55449
  • Facility Phone: 763 862-6596
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GEORGE M. MBURU
  • NPI Number: 1023023256
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2055074
LAB Type Pharmacy
Facility Name WALGREENS #07218
Street 12480 ABERDEEN ST NE
City BLAINE
State MN
ZIP 55449
Phone 763 862-6596
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type Pharmacy
Lab Director GEORGE M. MBURU

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