24D2230184 CLIA NUMBER - WALGREENS #07812

Laboratory Demographics

  • CLIA Code: 24D2230184
  • Facility Name: WALGREENS #07812
  • Facility Address: 21495 141ST AVE N
    ROGERS, MN
    ZIP 55374
  • Facility Phone: 763 428-5802
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AARON L. THEIS
  • NPI Number: 1932114162
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2230184
LAB Type Pharmacy
Facility Name WALGREENS #07812
Street 21495 141ST AVE N
City ROGERS
State MN
ZIP 55374
Phone 763 428-5802
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 AARON L. THEIS

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