24D1067673 CLIA NUMBER - CUB PHARMACY #1931

Laboratory Demographics

  • CLIA Code: 24D1067673
  • Facility Name: CUB PHARMACY #1931
  • Facility Address: 8421 LYNDALE AVE SOUTH
    BLOOMINGTON, MN
    ZIP 55420
  • Facility Phone: 952 346-8625
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW KELLY
  • NPI Number: 1477668515
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067673
LAB Type Pharmacy
Facility Name CUB PHARMACY #1931
Street 8421 LYNDALE AVE SOUTH
City BLOOMINGTON
State MN
ZIP 55420
Phone 952 346-8625
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 MATTHEW KELLY

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