24D0400873 CLIA NUMBER - WESTERN OB/GYN A DIVISON OF RIDGEVIEW CLINICS

Laboratory Demographics

  • CLIA Code: 24D0400873
  • Facility Name: WESTERN OB/GYN A DIVISON OF RIDGEVIEW CLINICS
  • Facility Address: 560 SOUTH MAPLE STREET SUITE 130
    WACONIA, MN
    ZIP 55387
  • Facility Phone: (952) 442-2137
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANDRAYA J. HULDEEN
  • NPI Number: 1093703316
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 24D0400873
LAB Type Physician Office
Facility Name WESTERN OB/GYN A DIVISON OF RIDGEVIEW CLINICS
Street 560 SOUTH MAPLE STREET SUITE 130
City WACONIA
State MN
ZIP 55387
Phone 9524422137
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/24/2025
Certificate Expiration Date 2/23/2027
Facility Type Physician Office
Lab Director ANDRAYA J. HULDEEN

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This page was last updated on: 5/18/2026