24D2058866 CLIA NUMBER - WALGREENS #13841

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Laboratory Demographics

CLIA Number: 24D2058866

Facility Name: WALGREENS #13841

Facility Address:
2500 WINNETKA AVE N
GOLDEN VALLEY, MN
ZIP 55427
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Facility Phone Number: 763 544-1747

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1386920148

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	24D2058866
LAB Type	Pharmacy
Facility Name	WALGREENS #13841
Street	2500 WINNETKA AVE N
City	GOLDEN VALLEY
State	MN
ZIP	55427
Phone	763 544-1747
CertificateType	4
CertificateEffectiveDate	12/18/2022
CertificateExpirationDate	12/17/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024