24D2230099 CLIA NUMBER - WALGREENS #12404

Laboratory Demographics

CLIA Number: 24D2230099

Facility Name: WALGREENS #12404

Facility Address:
3142 S SERVICE DR
RED WING, MN
ZIP 55066
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Facility Phone Number: 651 327-5000

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1982839544

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	24D2230099
LAB Type	Pharmacy
Facility Name	WALGREENS #12404
Street	3142 S SERVICE DR
City	RED WING
State	MN
ZIP	55066
Phone	651 327-5000
CertificateType	4
CertificateEffectiveDate	7/20/2023
CertificateExpirationDate	7/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024