24D0399238 CLIA NUMBER - M HEALTH FAIRVIEW CLINIC - PHALEN VILLAGE

Laboratory Demographics

CLIA Number: 24D0399238

Facility Name: M HEALTH FAIRVIEW CLINIC - PHALEN VILLAGE

Facility Address:
1414 MARYLAND AVE E
SAINT PAUL, MN
ZIP 55106
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Facility Phone Number: 651 772-3461

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1710212485

Taxonomy: 341600000X - Ambulance
An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).

CLIA Record

Field Name	Field Value
CLIA Number	24D0399238
LAB Type	Physician Office
Facility Name	M HEALTH FAIRVIEW CLINIC - PHALEN VILLAGE
Street	1414 MARYLAND AVE E
City	SAINT PAUL
State	MN
ZIP	55106
Phone	651 772-3461
CertificateType	1
CertificateEffectiveDate	12/23/2023
CertificateExpirationDate	12/22/2025
FacilityType	Accreditation

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