24D1067454 CLIA NUMBER - CUB PHARMACY #1612

Laboratory Demographics

  • CLIA Code: 24D1067454
  • Facility Name: CUB PHARMACY #1612
  • Facility Address: 1801 MARKET DRIVE
    STILLWATER, MN
    ZIP 55082
  • Facility Phone: 651 430-2362
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASSANDRA RITCHIE
  • NPI Number: 1598870636
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067454
LAB Type Pharmacy
Facility Name CUB PHARMACY #1612
Street 1801 MARKET DRIVE
City STILLWATER
State MN
ZIP 55082
Phone 651 430-2362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2025
Certificate Expiration Date 4/18/2027
Facility Type Pharmacy
Lab Director CASSANDRA RITCHIE

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