24D1067685 CLIA NUMBER - CUB PHARMACY # 1630

Laboratory Demographics

  • CLIA Code: 24D1067685
  • Facility Name: CUB PHARMACY # 1630
  • Facility Address: 246 - 57TH AVE NE
    FRIDLEY, MN
    ZIP 55432
  • Facility Phone: 763 586-9150
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALYSSA SCHRANK
  • NPI Number: 1831204973
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1067685
LAB Type Pharmacy
Facility Name CUB PHARMACY # 1630
Street 246 - 57TH AVE NE
City FRIDLEY
State MN
ZIP 55432
Phone 763 586-9150
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 ALYSSA SCHRANK

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