24D2060355 CLIA NUMBER - THRIFTY WHITE DRUG #762

Laboratory Demographics

  • CLIA Code: 24D2060355
  • Facility Name: THRIFTY WHITE DRUG #762
  • Facility Address: 6701 EVENSTAD DRIVE SUITE 200
    MAPLE GROVE, MN
    ZIP 55369
  • Facility Phone: 763 513-4300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LEE HANSON
  • NPI Number: 1588753198
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2060355
LAB Type Pharmacy
Facility Name THRIFTY WHITE DRUG #762
Street 6701 EVENSTAD DRIVE SUITE 200
City MAPLE GROVE
State MN
ZIP 55369
Phone 763 513-4300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2025
Certificate Expiration Date 6/10/2027
Facility Type Pharmacy
Lab Director LEE HANSON

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