24D2058869 CLIA NUMBER - WALGREENS #15439

Laboratory Demographics

  • CLIA Code: 24D2058869
  • Facility Name: WALGREENS #15439
  • Facility Address: 215 DODDRIDGE AVE
    CLOQUET, MN
    ZIP 55720
  • Facility Phone: 218 879-0091
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY TOLLEFSON
  • NPI Number: 1093052342
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2058869
LAB Type Pharmacy
Facility Name WALGREENS #15439
Street 215 DODDRIDGE AVE
City CLOQUET
State MN
ZIP 55720
Phone 218 879-0091
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director ASHLEY TOLLEFSON

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