24D1067472 CLIA NUMBER - CUB PHARMACY #1603

Laboratory Demographics

  • CLIA Code: 24D1067472
  • Facility Name: CUB PHARMACY #1603
  • Facility Address: 615 WEST CENTRAL ENTRANCE
    DULUTH, MN
    ZIP 55811
  • Facility Phone: 218 727-3010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JON SCHRAUT
  • NPI Number: 1588779623
  • Taxonomy: 3336C0003X - Pharmacy

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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
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 JON SCHRAUT

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