24D2301977 CLIA NUMBER - SUPERVALU PHARMACIES, INC D/B/A CUB PHARMACY #1718

Laboratory Demographics

  • CLIA Code: 24D2301977
  • Facility Name: SUPERVALU PHARMACIES, INC D/B/A CUB PHARMACY #1718
  • Facility Address: 2480 NW SCOTT ROAD SUITE 100
    ROCHESTER, MN
    ZIP 55901
  • Facility Phone: 507 224-4037
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAIGE F. LECLERC
  • NPI Number: 1922879683
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2301977
LAB Type Pharmacy
Facility Name SUPERVALU PHARMACIES, INC D/B/A CUB PHARMACY #1718
Street 2480 NW SCOTT ROAD SUITE 100
City ROCHESTER
State MN
ZIP 55901
Phone 507 224-4037
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Pharmacy
Lab Director PAIGE F. LECLERC

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