24D2279537 CLIA NUMBER - GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #01129

Laboratory Demographics

  • CLIA Code: 24D2279537
  • Facility Name: GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #01129
  • Facility Address: 4152 LAKELAND AVE NORTH
    ROBBINSDALE, MN
    ZIP 55422
  • Facility Phone: 763 535-2459
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VINH DANG
  • NPI Number: 1427157395
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2279537
LAB Type Pharmacy
Facility Name GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #01129
Street 4152 LAKELAND AVE NORTH
City ROBBINSDALE
State MN
ZIP 55422
Phone 763 535-2459
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Pharmacy
Lab Director VINH DANG

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