24D0400833 CLIA NUMBER - ALLINA HEALTH DEAN LAKES CLINIC

Laboratory Demographics

  • CLIA Code: 24D0400833
  • Facility Name: ALLINA HEALTH DEAN LAKES CLINIC
  • Facility Address: 4201 DEAN LAKES BLVD SUITE 120
    SHAKOPEE, MN
    ZIP 55379
  • Facility Phone: 612 767-8370
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. JENA C. MARTIN
  • NPI Number: 1013213461
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0400833
LAB Type Community Clinic
Facility Name ALLINA HEALTH DEAN LAKES CLINIC
Street 4201 DEAN LAKES BLVD SUITE 120
City SHAKOPEE
State MN
ZIP 55379
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