24D1067668 CLIA NUMBER - CUB PHARMACY #1928

Laboratory Demographics

  • CLIA Code: 24D1067668
  • Facility Name: CUB PHARMACY #1928
  • Facility Address: 1198 VIERLING DRIVE EAST
    SHAKOPEE, MN
    ZIP 55379
  • Facility Phone: 952 445-6344
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVEN LY
  • NPI Number: 1578678611
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D1067668
LAB Type Pharmacy
Facility Name CUB PHARMACY #1928
Street 1198 VIERLING DRIVE EAST
City SHAKOPEE
State MN
ZIP 55379
Phone 952 445-6344
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 STEVEN LY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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