24D2219158 CLIA NUMBER - WALGREENS #13685

Laboratory Demographics

  • CLIA Code: 24D2219158
  • Facility Name: WALGREENS #13685
  • Facility Address: 2635 RICE ST
    ROSEVILLE, MN
    ZIP 55113
  • Facility Phone: 651 483-3976
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REGINA M. CHONG
  • NPI Number: 1245246883
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2219158
LAB Type Pharmacy
Facility Name WALGREENS #13685
Street 2635 RICE ST
City ROSEVILLE
State MN
ZIP 55113
Phone 651 483-3976
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 REGINA M. CHONG

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