24D1067503 CLIA NUMBER - CUB PHARMACY # 1602

Laboratory Demographics

  • CLIA Code: 24D1067503
  • Facility Name: CUB PHARMACY # 1602
  • Facility Address: 1021 15TH AVENUE SOUTHEAST
    ROCHESTER, MN
    ZIP 55904
  • Facility Phone: 507 288-3234
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SWITA LI
  • NPI Number: 1003921149
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067503
LAB Type Pharmacy
Facility Name CUB PHARMACY # 1602
Street 1021 15TH AVENUE SOUTHEAST
City ROCHESTER
State MN
ZIP 55904
Phone 507 288-3234
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 SWITA LI

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