24D2231309 CLIA NUMBER - WALGREENS #05081

Laboratory Demographics

  • CLIA Code: 24D2231309
  • Facility Name: WALGREENS #05081
  • Facility Address: 4220 LEXINGTON AVE S
    EAGAN, MN
    ZIP 55123
  • Facility Phone: 651 686-1090
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEFALE T. BOGALE
  • NPI Number: 1154337798
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D2231309
LAB Type Pharmacy
Facility Name WALGREENS #05081
Street 4220 LEXINGTON AVE S
City EAGAN
State MN
ZIP 55123
Phone 651 686-1090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Pharmacy
Lab Director KEFALE T. BOGALE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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