24D0400190 CLIA NUMBER - THE ESTATES AT EXCELSIOR

Laboratory Demographics

  • CLIA Code: 24D0400190
  • Facility Name: THE ESTATES AT EXCELSIOR
  • Facility Address: 515 DIVISION STREET
    EXCELSIOR, MN
    ZIP 55331
  • Facility Phone: 952 474-5488
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SARAH FRIE
  • NPI Number: 1053859520
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0400190
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name THE ESTATES AT EXCELSIOR
Street 515 DIVISION STREET
City EXCELSIOR
State MN
ZIP 55331
Phone 952 474-5488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SARAH FRIE

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