CLIA lab
CLIA 24D2279659: Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #05308
Lakeville, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D2279659 belongs to Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #05308 in Lakeville, MN.
Certificate of Waiver, effective April 5, 2025, expires April 4, 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 5, 2025
- Certificate expiration
- April 4, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 5, 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
- 24D2279659
- Lab name
- Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #05308
- Address
- 17665 Kenwood Tr, Lakeville, MN 55044
- Phone
- (952) 435-3784
- 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 #05308 in Lakeville?
24D2279659, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #05308 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D2279659 expire?
The CMS file lists April 4, 2027 as the certificate expiration date; the certificate took effect April 5, 2025.