24D2123027 CLIA NUMBER - THRIFTY WHITE PHARMACY #787

Laboratory Demographics

  • CLIA Code: 24D2123027
  • Facility Name: THRIFTY WHITE PHARMACY #787
  • Facility Address: 246 ELM STREET WEST
    ANNANDALE, MN
    ZIP 55302
  • Facility Phone: 320 274-3062
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAKSIM KAZLOUSKI
  • NPI Number: 1306394887
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2123027
LAB Type Pharmacy
Facility Name THRIFTY WHITE PHARMACY #787
Street 246 ELM STREET WEST
City ANNANDALE
State MN
ZIP 55302
Phone 320 274-3062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Pharmacy
Lab Director MAKSIM KAZLOUSKI

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