24D2162853 CLIA NUMBER - COKATO DRUG, LLC DBA COKATO KEAVENY DRUG

Laboratory Demographics

  • CLIA Code: 24D2162853
  • Facility Name: COKATO DRUG, LLC DBA COKATO KEAVENY DRUG
  • Facility Address: 205 BROADWAY AVE S
    COKATO, MN
    ZIP 55321
  • Facility Phone: 320 286-2380
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY J. KEAVENY
  • NPI Number: 1982168142
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2162853
LAB Type Pharmacy
Facility Name COKATO DRUG, LLC DBA COKATO KEAVENY DRUG
Street 205 BROADWAY AVE S
City COKATO
State MN
ZIP 55321
Phone 320 286-2380
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Pharmacy
Lab Director KELLY J. KEAVENY

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