24D2288602 CLIA NUMBER - WALGREENS 12510

Laboratory Demographics

  • CLIA Code: 24D2288602
  • Facility Name: WALGREENS 12510
  • Facility Address: 6025 SHENANDOAH LN N
    PLYMOUTH, MN
    ZIP 55446
  • Facility Phone: 763 252-1300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBBIE S. SLOVUT
  • NPI Number: 1366680688
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2288602
LAB Type Pharmacy
Facility Name WALGREENS 12510
Street 6025 SHENANDOAH LN N
City PLYMOUTH
State MN
ZIP 55446
Phone 763 252-1300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Pharmacy
Lab Director DEBBIE S. SLOVUT

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