24D0398631 CLIA NUMBER - M HEALTH FAIRVIEW CLINIC - WYOMING

Laboratory Demographics

CLIA Number: 24D0398631

Facility Name: M HEALTH FAIRVIEW CLINIC - WYOMING

Facility Address:
5200 FAIRVIEW BOULEVARD
WYOMING, MN
ZIP 55092
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Facility Phone Number: 651 982-7224

Facility Type: Community Clinic

Certificate Type: Accreditation

NPI Number: 1659525848

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D0398631
LAB Type	Community Clinic
Facility Name	M HEALTH FAIRVIEW CLINIC - WYOMING
Street	5200 FAIRVIEW BOULEVARD
City	WYOMING
State	MN
ZIP	55092
Phone	651 982-7224
CertificateType	1
CertificateEffectiveDate	1/3/2023
CertificateExpirationDate	1/2/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024