24D2222767 CLIA NUMBER - WALGREENS #10641

Laboratory Demographics

  • CLIA Code: 24D2222767
  • Facility Name: WALGREENS #10641
  • Facility Address: 1274 TOWN CENTRE DR
    EAGAN, MN
    ZIP 55123
  • Facility Phone: 651 452-5320
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GUTATA B. URGESSA
  • NPI Number: 1215942529
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2222767
LAB Type Pharmacy
Facility Name WALGREENS #10641
Street 1274 TOWN CENTRE DR
City EAGAN
State MN
ZIP 55123
Phone 651 452-5320
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2025
Certificate Expiration Date 4/29/2027
Facility Type Pharmacy
Lab Director GUTATA B. URGESSA

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