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24D2291070 CLIA NUMBER - WALGREENS 06447

Laboratory Demographics

CLIA Number: 24D2291070

Facility Name: WALGREENS 06447

Facility Address:
2387 MOUNDS VIEW BLVD
MOUNDS VIEW, MN
ZIP 55112
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Facility Phone Number: 763 784-8925

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1760497994

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 24D2291070
LAB Type Pharmacy
Facility Name WALGREENS 06447
Street 2387 MOUNDS VIEW BLVD
City MOUNDS VIEW
State MN
ZIP 55112
Phone 763 784-8925
CertificateType 4
CertificateEffectiveDate 10/4/2023
CertificateExpirationDate 10/3/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024