24D2219148 CLIA NUMBER - WALGREENS #06916

Laboratory Demographics

  • CLIA Code: 24D2219148
  • Facility Name: WALGREENS #06916
  • Facility Address: 6061 OSGOOD AVE N
    OAK PARK HEIGHTS, MN
    ZIP 55082
  • Facility Phone: 651 689-0046
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GRANT SYVERSON
  • NPI Number: 1841205077
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2219148
LAB Type Pharmacy
Facility Name WALGREENS #06916
Street 6061 OSGOOD AVE N
City OAK PARK HEIGHTS
State MN
ZIP 55082
Phone 651 689-0046
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Pharmacy
Lab Director GRANT SYVERSON

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