24D2217660 CLIA NUMBER - GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #16056

Laboratory Demographics

CLIA Number: 24D2217660

Facility Name: GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #16056

Facility Address:
8225 FLYING CLOUD DR
EDEN PRAIRIE, MN
ZIP 55344
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871515551

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	24D2217660
LAB Type	Pharmacy
Facility Name	GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #16056
Street	8225 FLYING CLOUD DR
City	EDEN PRAIRIE
State	MN
ZIP	55344
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	3/23/2023
CertificateExpirationDate	3/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024