24D2287373 CLIA NUMBER - WALGREENS 05634

Laboratory Demographics

  • CLIA Code: 24D2287373
  • Facility Name: WALGREENS 05634
  • Facility Address: 7560 160TH ST W
    LAKEVILLE, MN
    ZIP 55044
  • Facility Phone: 952 891-1167
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMAL MOHAMED
  • NPI Number: 1679588800
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2287373
LAB Type Pharmacy
Facility Name WALGREENS 05634
Street 7560 160TH ST W
City LAKEVILLE
State MN
ZIP 55044
Phone 952 891-1167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director AMAL MOHAMED

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