24D2206188 CLIA NUMBER - WALGREENS #11956

Laboratory Demographics

  • CLIA Code: 24D2206188
  • Facility Name: WALGREENS #11956
  • Facility Address: 17 DIVISION ST
    WAITE PARK, MN
    ZIP 56387
  • Facility Phone: 320 203-1035
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN A. BARTELS
  • NPI Number: 1760621197
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2206188
LAB Type Pharmacy
Facility Name WALGREENS #11956
Street 17 DIVISION ST
City WAITE PARK
State MN
ZIP 56387
Phone 320 203-1035
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Pharmacy
Lab Director KEVIN A. BARTELS

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This page was last updated on: 6/4/2025