24D2212709 CLIA NUMBER - WALGREENS #11421

Laboratory Demographics

  • CLIA Code: 24D2212709
  • Facility Name: WALGREENS #11421
  • Facility Address: 1180 ARCADE ST
    SAINT PAUL, MN
    ZIP 55106
  • Facility Phone: 651 251-9887
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NANCY MOUA
  • NPI Number: 1336321025
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2212709
LAB Type Pharmacy
Facility Name WALGREENS #11421
Street 1180 ARCADE ST
City SAINT PAUL
State MN
ZIP 55106
Phone 651 251-9887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Pharmacy
Lab Director NANCY MOUA

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