24D0402168 CLIA NUMBER - ESTATES AT BLOOMINGTON, THE

Laboratory Demographics

  • CLIA Code: 24D0402168
  • Facility Name: ESTATES AT BLOOMINGTON, THE
  • Facility Address: 9200 NICOLLET AVENUE SOUTH
    BLOOMINGTON, MN
    ZIP 55420
  • Facility Phone: 952 881-8676
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SIMON MITTAL
  • NPI Number: 1952849416
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D0402168
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ESTATES AT BLOOMINGTON, THE
Street 9200 NICOLLET AVENUE SOUTH
City BLOOMINGTON
State MN
ZIP 55420
Phone 952 881-8676
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 SIMON MITTAL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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