24D1067474 CLIA NUMBER - CUB PHARMACY #1918

Laboratory Demographics

  • CLIA Code: 24D1067474
  • Facility Name: CUB PHARMACY #1918
  • Facility Address: 1059 MEADOWLANDS DRIVE
    WHITE BEAR LAKE, MN
    ZIP 55110
  • Facility Phone: 651 426-5006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATIE TRUMBLE
  • NPI Number: 1760597801
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067474
LAB Type Pharmacy
Facility Name CUB PHARMACY #1918
Street 1059 MEADOWLANDS DRIVE
City WHITE BEAR LAKE
State MN
ZIP 55110
Phone 651 426-5006
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 KATIE TRUMBLE

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