24D1067653 CLIA NUMBER - CUB PHARMACY #1640

Laboratory Demographics

  • CLIA Code: 24D1067653
  • Facility Name: CUB PHARMACY #1640
  • Facility Address: 14075 HIGHWAY 13
    SAVAGE, MN
    ZIP 55378
  • Facility Phone: 952 447-1611
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DOLLY PANCHAL
  • NPI Number: 1457466591
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067653
LAB Type Pharmacy
Facility Name CUB PHARMACY #1640
Street 14075 HIGHWAY 13
City SAVAGE
State MN
ZIP 55378
Phone 952 447-1611
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 DOLLY PANCHAL

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