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24D2230147 CLIA NUMBER - WALGREENS #05882

Laboratory Demographics

CLIA Number: 24D2230147

Facility Name: WALGREENS #05882

Facility Address:
4200 WINNETKA AVE N
NEW HOPE, MN
ZIP 55428
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Facility Phone Number: 763 545-6466

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1306851621

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 24D2230147
LAB Type Pharmacy
Facility Name WALGREENS #05882
Street 4200 WINNETKA AVE N
City NEW HOPE
State MN
ZIP 55428
Phone 763 545-6466
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