24D1067475 CLIA NUMBER - CUB PHARMACY #1600

Laboratory Demographics

  • CLIA Code: 24D1067475
  • Facility Name: CUB PHARMACY #1600
  • Facility Address: 8150 WEDGEWOOD LANE
    MAPLE GROVE, MN
    ZIP 55369
  • Facility Phone: 763 494-8355
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAYLA LEPARD
  • NPI Number: 1679688717
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067475
LAB Type Pharmacy
Facility Name CUB PHARMACY #1600
Street 8150 WEDGEWOOD LANE
City MAPLE GROVE
State MN
ZIP 55369
Phone 763 494-8355
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 KAYLA LEPARD

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