24D2294409 CLIA NUMBER - WALGREENS 01916

Laboratory Demographics

  • CLIA Code: 24D2294409
  • Facility Name: WALGREENS 01916
  • Facility Address: 13622 GROVE DR
    MAPLE GROVE, MN
    ZIP 55311
  • Facility Phone: 763 420-7788
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BARUN DHAKAL
  • NPI Number: 1124033436
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2294409
LAB Type Pharmacy
Facility Name WALGREENS 01916
Street 13622 GROVE DR
City MAPLE GROVE
State MN
ZIP 55311
Phone 763 420-7788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Pharmacy
Lab Director BARUN DHAKAL

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