24D0399838 CLIA NUMBER - PEDIATRIC & YOUNG ADULT CLINIC

Laboratory Demographics

  • CLIA Code: 24D0399838
  • Facility Name: PEDIATRIC & YOUNG ADULT CLINIC
  • Facility Address: 3470 WASHINGTON DRIVE SUITE 201
    EAGAN, MN
    ZIP 55122
  • Facility Phone: 651 452-8622
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: TAMMI PLOTNIK
  • NPI Number: 1205078300
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0399838
LAB Type Physician Office
Facility Name PEDIATRIC & YOUNG ADULT CLINIC
Street 3470 WASHINGTON DRIVE SUITE 201
City EAGAN
State MN
ZIP 55122
Phone 651 452-8622
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director TAMMI PLOTNIK

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