24D2055631 CLIA NUMBER - THRIFTY WHITE PHARMACY #767

Laboratory Demographics

  • CLIA Code: 24D2055631
  • Facility Name: THRIFTY WHITE PHARMACY #767
  • Facility Address: 127 2ND AVENUE SW
    MILACA, MN
    ZIP 56353
  • Facility Phone: (320) 982-3300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADEBOLA DUROSAWO
  • NPI Number: 1750444857
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2055631
LAB Type Pharmacy
Facility Name THRIFTY WHITE PHARMACY #767
Street 127 2ND AVENUE SW
City MILACA
State MN
ZIP 56353
Phone 3209823300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Pharmacy
Lab Director ADEBOLA DUROSAWO

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This page was last updated on: 5/15/2026