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24D2230180 CLIA NUMBER - WALGREENS #09511

Laboratory Demographics

CLIA Number: 24D2230180

Facility Name: WALGREENS #09511

Facility Address:
7845 PORTLAND AVE S
BLOOMINGTON, MN
ZIP 55420
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Facility Phone Number: 952 881-1253

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1043225352

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 24D2230180
LAB Type Pharmacy
Facility Name WALGREENS #09511
Street 7845 PORTLAND AVE S
City BLOOMINGTON
State MN
ZIP 55420
Phone 952 881-1253
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