24D2279593 CLIA NUMBER - GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #04573

Laboratory Demographics

  • CLIA Code: 24D2279593
  • Facility Name: GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #04573
  • Facility Address: 2650 RICE ST
    LITTLE CANADA, MN
    ZIP 55113
  • Facility Phone: 651 484-0504
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIN SIMON LAMPRECHT
  • NPI Number: 1265663991
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2279593
LAB Type Pharmacy
Facility Name GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #04573
Street 2650 RICE ST
City LITTLE CANADA
State MN
ZIP 55113
Phone 651 484-0504
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 KRISTIN SIMON LAMPRECHT

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