24D2230180 CLIA NUMBER - WALGREENS #09511

Laboratory Demographics

  • CLIA Code: 24D2230180
  • Facility Name: WALGREENS #09511
  • Facility Address: 7845 PORTLAND AVE S
    BLOOMINGTON, MN
    ZIP 55420
  • Facility Phone: 952 881-1253
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY M. CASEY
  • NPI Number: 1043225352
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2230180
LAB Type Pharmacy
Facility Name WALGREENS #09511
Street 7845 PORTLAND AVE S
City BLOOMINGTON
State MN
ZIP 55420
Phone 952 881-1253
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Pharmacy
Lab Director TIMOTHY M. CASEY

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