24D0399787 CLIA NUMBER - ALLINA HEALTH EAGAN CLINIC

Laboratory Demographics

  • CLIA Code: 24D0399787
  • Facility Name: ALLINA HEALTH EAGAN CLINIC
  • Facility Address: 1110 YANKEE DOODLE ROAD
    EAGAN, MN
    ZIP 55121
  • Facility Phone: 612 767-8370
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. JENA C. MARTIN
  • NPI Number: 1780980599
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 24D0399787
LAB Type Community Clinic
Facility Name ALLINA HEALTH EAGAN CLINIC
Street 1110 YANKEE DOODLE ROAD
City EAGAN
State MN
ZIP 55121
Phone 612 767-8370
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Community Clinic
Lab Director DR. JENA C. MARTIN

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