24D2217797 CLIA NUMBER - WALGREENS #11952

Laboratory Demographics

  • CLIA Code: 24D2217797
  • Facility Name: WALGREENS #11952
  • Facility Address: 4205 EGAN DR
    SAVAGE, MN
    ZIP 55378
  • Facility Phone: 952 746-2202
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATIE L. MAXWELL
  • NPI Number: 1205099561
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2217797
LAB Type Pharmacy
Facility Name WALGREENS #11952
Street 4205 EGAN DR
City SAVAGE
State MN
ZIP 55378
Phone 952 746-2202
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director KATIE L. MAXWELL

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