24D2067313 CLIA NUMBER - GOODRICH PHARMACY

Laboratory Demographics

  • CLIA Code: 24D2067313
  • Facility Name: GOODRICH PHARMACY
  • Facility Address: 23122 ST FRANCIS BLVD NW
    ST FRANCIS, MN
    ZIP 55070
  • Facility Phone: 763 753-0222
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERICA L. BURMAN
  • NPI Number: 1891706305
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2067313
LAB Type Pharmacy
Facility Name GOODRICH PHARMACY
Street 23122 ST FRANCIS BLVD NW
City ST FRANCIS
State MN
ZIP 55070
Phone 763 753-0222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2024
Certificate Expiration Date 11/28/2026
Facility Type Pharmacy
Lab Director ERICA L. BURMAN

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