24D2230396 CLIA NUMBER - WALGREENS #04320

Laboratory Demographics

  • CLIA Code: 24D2230396
  • Facility Name: WALGREENS #04320
  • Facility Address: 6390 BROOKLYN BLVD
    BROOKLYN CENTER, MN
    ZIP 55429
  • Facility Phone: (763) 585-9946
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANIS P. ABDILLAHI
  • NPI Number: 1669487989
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2230396
LAB Type Pharmacy
Facility Name WALGREENS #04320
Street 6390 BROOKLYN BLVD
City BROOKLYN CENTER
State MN
ZIP 55429
Phone 7635859946
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Pharmacy
Lab Director ANIS P. ABDILLAHI

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This page was last updated on: 5/18/2026