24D2080073 CLIA NUMBER - CUB PHARMACY #1693

Laboratory Demographics

  • CLIA Code: 24D2080073
  • Facility Name: CUB PHARMACY #1693
  • Facility Address: 1104 LAGOON AVE
    MINNEAPOLIS, MN
    ZIP 55408
  • Facility Phone: 612 821-0547
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MEGHAN KIRCHHOFF
  • NPI Number: 1598176117
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2080073
LAB Type Pharmacy
Facility Name CUB PHARMACY #1693
Street 1104 LAGOON AVE
City MINNEAPOLIS
State MN
ZIP 55408
Phone 612 821-0547
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Pharmacy
Lab Director MEGHAN KIRCHHOFF

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