24D0402186 CLIA NUMBER - MARTIN LUTHER CARE CENTER

Laboratory Demographics

  • CLIA Code: 24D0402186
  • Facility Name: MARTIN LUTHER CARE CENTER
  • Facility Address: 1401 E 100TH ST
    BLOOMINGTON, MN
    ZIP 55425
  • Facility Phone: (952) 888-7751
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JESSIE KELLSTADT
  • NPI Number: 1629148929
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D0402186
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MARTIN LUTHER CARE CENTER
Street 1401 E 100TH ST
City BLOOMINGTON
State MN
ZIP 55425
Phone 9528887751
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 JESSIE KELLSTADT

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: 5/18/2026