24D2227933 CLIA NUMBER - WALGREENS #09727

Laboratory Demographics

  • CLIA Code: 24D2227933
  • Facility Name: WALGREENS #09727
  • Facility Address: 14020 PILOT KNOB RD
    APPLE VALLEY, MN
    ZIP 55124
  • Facility Phone: 952 322-1163
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL BESONG
  • NPI Number: 1063427490
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2227933
LAB Type Pharmacy
Facility Name WALGREENS #09727
Street 14020 PILOT KNOB RD
City APPLE VALLEY
State MN
ZIP 55124
Phone 952 322-1163
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type Pharmacy
Lab Director PAUL BESONG

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