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24D1067472 CLIA NUMBER - CUB PHARMACY #1603

Laboratory Demographics

CLIA Number: 24D1067472

Facility Name: CUB PHARMACY #1603

Facility Address:
615 WEST CENTRAL ENTRANCE
DULUTH, MN
ZIP 55811
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Facility Phone Number: 218 727-3010

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1588779623

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 24D1067472
LAB Type Pharmacy
Facility Name CUB PHARMACY #1603
Street 615 WEST CENTRAL ENTRANCE
City DULUTH
State MN
ZIP 55811
Phone 218 727-3010
CertificateType 4
CertificateEffectiveDate 4/19/2023
CertificateExpirationDate 4/18/2025
FacilityType Waiver

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