24D0401289 CLIA NUMBER - ANDREW RESIDENCE

Laboratory Demographics

  • CLIA Code: 24D0401289
  • Facility Name: ANDREW RESIDENCE
  • Facility Address: 1215 S 9TH STREET
    MINNEAPOLIS, MN
    ZIP 55404
  • Facility Phone: 612 333-0111
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER M. FITCH
  • NPI Number: 1861452278
  • Taxonomy: 310500000X - Intermediate Care Facility, Mental Illness

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CLIA Record

Field Name Field Value
CLIA Number 24D0401289
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ANDREW RESIDENCE
Street 1215 S 9TH STREET
City MINNEAPOLIS
State MN
ZIP 55404
Phone 612 333-0111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JENNIFER M. FITCH

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