24D1067648 CLIA NUMBER - CUB PHARMACY #1654

Laboratory Demographics

  • CLIA Code: 24D1067648
  • Facility Name: CUB PHARMACY #1654
  • Facility Address: 9655 COLORADO LANE N
    BROOKLYN PARK, MN
    ZIP 55445
  • Facility Phone: 763 315-0737
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: YANG MOUA
  • NPI Number: 1831293067
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067648
LAB Type Pharmacy
Facility Name CUB PHARMACY #1654
Street 9655 COLORADO LANE N
City BROOKLYN PARK
State MN
ZIP 55445
Phone 763 315-0737
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2025
Certificate Expiration Date 4/23/2027
Facility Type Pharmacy
Lab Director YANG MOUA

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