24D2222478 CLIA NUMBER - WALGREENS #09065

Laboratory Demographics

  • CLIA Code: 24D2222478
  • Facility Name: WALGREENS #09065
  • Facility Address: 401 5TH ST W
    NORTHFIELD, MN
    ZIP 55057
  • Facility Phone: 507 645-9658
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANE A. HAVRON
  • NPI Number: 1922013150
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D2222478
LAB Type Pharmacy
Facility Name WALGREENS #09065
Street 401 5TH ST W
City NORTHFIELD
State MN
ZIP 55057
Phone 507 645-9658
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Pharmacy
Lab Director SHANE A. HAVRON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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