24D0400936 CLIA NUMBER - PARK NICOLLET CLINIC - WAYZATA

Laboratory Demographics

CLIA Number: 24D0400936

Facility Name: PARK NICOLLET CLINIC - WAYZATA

Facility Address:
250 NORTH CENTRAL AVENUE SUITE #224
WAYZATA, MN
ZIP 55391
Get Directions

Facility Phone Number: 952 993-8232

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1285713594

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	24D0400936
LAB Type	Physician Office
Facility Name	PARK NICOLLET CLINIC - WAYZATA
Street	250 NORTH CENTRAL AVENUE SUITE #224
City	WAYZATA
State	MN
ZIP	55391
Phone	952 993-8232
CertificateType	1
CertificateEffectiveDate	10/2/2022
CertificateExpirationDate	10/1/2024
FacilityType	Accreditation

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024