24D2230147 CLIA NUMBER - WALGREENS #5882

Laboratory Demographics

  • CLIA Code: 24D2230147
  • Facility Name: WALGREENS #5882
  • Facility Address: 4200 WINNETKA AVE N
    NEW HOPE, MN
    ZIP 55428
  • Facility Phone: 763 545-6466
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAVITHA P. THOMAS
  • NPI Number: 1306851621
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2230147
LAB Type Pharmacy
Facility Name WALGREENS #5882
Street 4200 WINNETKA AVE N
City NEW HOPE
State MN
ZIP 55428
Phone 763 545-6466
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2023
Certificate Expiration Date 7/19/2025
Facility Type Pharmacy
Lab Director KAVITHA P. THOMAS

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This page was last updated on: 3/20/2025