CLIA lab

CLIA 24D2279593: Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #04573

Little Canada, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 24D2279593 belongs to Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #04573 in Little Canada, MN.

Certificate of Waiver, effective April 4, 2025, expires April 3, 2027.

Active in the CMS Provider of Services file posted October 16, 2026.

Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page

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Certificate

Certificate type
Certificate of Waiver
Certificate effective
April 4, 2025
Certificate expiration
April 3, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
April 4, 2023
Facility type
Pharmacy
Ownership (control type)
Proprietary
Lab classification
CLIA laboratory

Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page

Lab and contact

CLIA number
24D2279593
Lab name
Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #04573
Address
2650 Rice St, Little Canada, MN 55113
Phone
(651) 484-0504
Fax
(401) 216-0351

Annual test volume the lab reported

Waived tests
13,000

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

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Related

Questions

What is the CLIA number for Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #04573 in Little Canada?

24D2279593, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #04573 hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 24D2279593 expire?

The CMS file lists April 3, 2027 as the certificate expiration date; the certificate took effect April 4, 2025.

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