24D0398299 CLIA NUMBER - ALLINA HEALTH LAKEVILLE SOUTH CLINIC

Laboratory Demographics

  • CLIA Code: 24D0398299
  • Facility Name: ALLINA HEALTH LAKEVILLE SOUTH CLINIC
  • Facility Address: 20795 KEOKUK AVE
    LAKEVILLE, MN
    ZIP 55044
  • Facility Phone: 612 863-0408
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: ERIK JENSON
  • NPI Number: 1548200405
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0398299
LAB Type Community Clinic
Facility Name ALLINA HEALTH LAKEVILLE SOUTH CLINIC
Street 20795 KEOKUK AVE
City LAKEVILLE
State MN
ZIP 55044
Phone 612 863-0408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Community Clinic
Lab Director ERIK JENSON

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