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24D1067479 CLIA NUMBER - CUB PHARMACY #1921

Laboratory Demographics

CLIA Number: 24D1067479

Facility Name: CUB PHARMACY #1921

Facility Address:
8432 TAMARACK VILLAGE
WOODBURY, MN
ZIP 55125
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Facility Phone Number: 651 702-1032

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1841305984

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 24D1067479
LAB Type Pharmacy
Facility Name CUB PHARMACY #1921
Street 8432 TAMARACK VILLAGE
City WOODBURY
State MN
ZIP 55125
Phone 651 702-1032
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