24D2204103 CLIA NUMBER - ROLSETH DRUG CO

Laboratory Demographics

  • CLIA Code: 24D2204103
  • Facility Name: ROLSETH DRUG CO
  • Facility Address: 107 LAKE STREET N
    FOREST LAKE, MN
    ZIP 55025
  • Facility Phone: 651 464-2114
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TOM HAAS
  • NPI Number: 1265059075
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2204103
LAB Type Pharmacy
Facility Name ROLSETH DRUG CO
Street 107 LAKE STREET N
City FOREST LAKE
State MN
ZIP 55025
Phone 651 464-2114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Pharmacy
Lab Director TOM HAAS

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