24D2154975 CLIA NUMBER - WALMART PHARMACY 10-1864

Laboratory Demographics

  • CLIA Code: 24D2154975
  • Facility Name: WALMART PHARMACY 10-1864
  • Facility Address: 8000 LAKELAND AVE N
    BROOKLYN PARK, MN
    ZIP 55445
  • Facility Phone: 763 424-7077
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA S. OSTLUND
  • NPI Number: 1366469744
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2154975
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1864
Street 8000 LAKELAND AVE N
City BROOKLYN PARK
State MN
ZIP 55445
Phone 763 424-7077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Pharmacy
Lab Director LISA S. OSTLUND

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