24D2186226 CLIA NUMBER - CUB PHARMACY #1965

Laboratory Demographics

  • CLIA Code: 24D2186226
  • Facility Name: CUB PHARMACY #1965
  • Facility Address: 900 CENTRAL AVENUE
    SAINT MICHAEL, MN
    ZIP 55376
  • Facility Phone: 763 497-3568
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE DUBE
  • NPI Number: 1780213587
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2186226
LAB Type Pharmacy
Facility Name CUB PHARMACY #1965
Street 900 CENTRAL AVENUE
City SAINT MICHAEL
State MN
ZIP 55376
Phone 763 497-3568
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Pharmacy
Lab Director STEPHANIE DUBE

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