24D2279550 CLIA NUMBER - GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #00241

Laboratory Demographics

  • CLIA Code: 24D2279550
  • Facility Name: GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #00241
  • Facility Address: 19605 PILOT KNOB RD
    FARMINGTON, MN
    ZIP 55024
  • Facility Phone: 651 463-3693
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MINH KHOA NGUYEN
  • NPI Number: 1770770828
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2279550
LAB Type Pharmacy
Facility Name GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #00241
Street 19605 PILOT KNOB RD
City FARMINGTON
State MN
ZIP 55024
Phone 651 463-3693
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 MINH KHOA NGUYEN

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