24D2279591 CLIA NUMBER - GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #03313

Laboratory Demographics

  • CLIA Code: 24D2279591
  • Facility Name: GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #03313
  • Facility Address: 1471 ROBERT ST S
    WEST SAINT PAUL, MN
    ZIP 55118
  • Facility Phone: 651 552-6029
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAI HOANG
  • NPI Number: 1942471933
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2279591
LAB Type Pharmacy
Facility Name GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #03313
Street 1471 ROBERT ST S
City WEST SAINT PAUL
State MN
ZIP 55118
Phone 651 552-6029
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 MAI HOANG

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