24D0400712 CLIA NUMBER - CHILDREN'S CLINIC NETWORK DBA PARTNERS IN PEDIATRICS MAPLE GROVE

Laboratory Demographics

  • CLIA Code: 24D0400712
  • Facility Name: CHILDREN'S CLINIC NETWORK DBA PARTNERS IN PEDIATRICS MAPLE GROVE
  • Facility Address: 12720 BASS LAKE ROAD
    MAPLE GROVE, MN
    ZIP 55369
  • Facility Phone: 763 559-2861
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. VEDAVATHI BELLAMKONDAATHMARAM
  • NPI Number: 1013278720
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0400712
LAB Type Physician Office
Facility Name CHILDREN'S CLINIC NETWORK DBA PARTNERS IN PEDIATRICS MAPLE GROVE
Street 12720 BASS LAKE ROAD
City MAPLE GROVE
State MN
ZIP 55369
Phone 763 559-2861
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 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Physician Office
Lab Director DR. VEDAVATHI BELLAMKONDAATHMARAM

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