24D1067656 CLIA NUMBER - CUB PHARMACY #1644

Laboratory Demographics

  • CLIA Code: 24D1067656
  • Facility Name: CUB PHARMACY #1644
  • Facility Address: 7900 MARKET BLVD
    CHANHASSEN, MN
    ZIP 55317
  • Facility Phone: 952 934-2865
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBORAH HARTMAN
  • NPI Number: 1629183769
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067656
LAB Type Pharmacy
Facility Name CUB PHARMACY #1644
Street 7900 MARKET BLVD
City CHANHASSEN
State MN
ZIP 55317
Phone 952 934-2865
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 DEBORAH HARTMAN

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