24D2226024 CLIA NUMBER - WALGREENS #02496

Laboratory Demographics

  • CLIA Code: 24D2226024
  • Facility Name: WALGREENS #02496
  • Facility Address: 14700 LAC LAVON DR
    BURNSVILLE, MN
    ZIP 55306
  • Facility Phone: 952 432-4471
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAURA G. CARLISLE
  • NPI Number: 1124033444
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2226024
LAB Type Pharmacy
Facility Name WALGREENS #02496
Street 14700 LAC LAVON DR
City BURNSVILLE
State MN
ZIP 55306
Phone 952 432-4471
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director LAURA G. CARLISLE

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