24D2070422 CLIA NUMBER - WALGREENS #15560

Laboratory Demographics

  • CLIA Code: 24D2070422
  • Facility Name: WALGREENS #15560
  • Facility Address: 2700 LINCOLN DR
    ROSEVILLE, MN
    ZIP 55113
  • Facility Phone: 651 636-9369
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN NGUYEN
  • NPI Number: 1366458762
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2070422
LAB Type Pharmacy
Facility Name WALGREENS #15560
Street 2700 LINCOLN DR
City ROSEVILLE
State MN
ZIP 55113
Phone 651 636-9369
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Pharmacy
Lab Director BRIAN NGUYEN

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