24D1067669 CLIA NUMBER - CUB PHARMACY # 1929

Laboratory Demographics

  • CLIA Code: 24D1067669
  • Facility Name: CUB PHARMACY # 1929
  • Facility Address: 1008 HWY 55 E
    BUFFALO, MN
    ZIP 55313
  • Facility Phone: 763 682-5828
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TODD A. WAHLSTROM
  • NPI Number: 1487769527
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067669
LAB Type Pharmacy
Facility Name CUB PHARMACY # 1929
Street 1008 HWY 55 E
City BUFFALO
State MN
ZIP 55313
Phone 763 682-5828
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 TODD A. WAHLSTROM

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