24D0402086 CLIA NUMBER - NEIGHBORHOOD HEALTH SOURCE CENTRAL AVENUE CLINIC

Laboratory Demographics

  • CLIA Code: 24D0402086
  • Facility Name: NEIGHBORHOOD HEALTH SOURCE CENTRAL AVENUE CLINIC
  • Facility Address: 2301 CENTRAL AVENUE NE
    MINNEAPOLIS, MN
    ZIP 55418
  • Facility Phone: 612 277-3183
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Certificate of Compliance
  • Lab Director: ROBIN BRESETTE
  • NPI Number: 1659323459
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0402086
LAB Type Federally Qualified Health Center
Facility Name NEIGHBORHOOD HEALTH SOURCE CENTRAL AVENUE CLINIC
Street 2301 CENTRAL AVENUE NE
City MINNEAPOLIS
State MN
ZIP 55418
Phone 612 277-3183
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Federally Qualified Health Center
Lab Director ROBIN BRESETTE

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This page was last updated on: 3/20/2025