24D1067464 CLIA NUMBER - CUB PHARMACY # 1616

Laboratory Demographics

  • CLIA Code: 24D1067464
  • Facility Name: CUB PHARMACY # 1616
  • Facility Address: 1940 CLIFF LAKE ROAD
    EAGAN, MN
    ZIP 55122
  • Facility Phone: 651 454-5150
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WADE TRANBY
  • NPI Number: 1689789729
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067464
LAB Type Pharmacy
Facility Name CUB PHARMACY # 1616
Street 1940 CLIFF LAKE ROAD
City EAGAN
State MN
ZIP 55122
Phone 651 454-5150
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 WADE TRANBY

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