24D0401679 CLIA NUMBER - REDEEMER RESIDENCE INC

Laboratory Demographics

  • CLIA Code: 24D0401679
  • Facility Name: REDEEMER RESIDENCE INC
  • Facility Address: 625 WEST 31ST STREET
    MINNEAPOLIS, MN
    ZIP 55408
  • Facility Phone: 612 827-2555
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JESSICA DAVENPORT
  • NPI Number: 1619965365
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0401679
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name REDEEMER RESIDENCE INC
Street 625 WEST 31ST STREET
City MINNEAPOLIS
State MN
ZIP 55408
Phone 612 827-2555
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 JESSICA DAVENPORT

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