24D1067679 CLIA NUMBER - CUB PHARMACY #1649

Laboratory Demographics

  • CLIA Code: 24D1067679
  • Facility Name: CUB PHARMACY #1649
  • Facility Address: 2600 RICE CREEK ROAD
    NEW BRIGHTON, MN
    ZIP 55112
  • Facility Phone: 651 631-8202
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATALIE HEYL
  • NPI Number: 1821103961
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067679
LAB Type Pharmacy
Facility Name CUB PHARMACY #1649
Street 2600 RICE CREEK ROAD
City NEW BRIGHTON
State MN
ZIP 55112
Phone 651 631-8202
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 NATALIE HEYL

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