24D0402648 CLIA NUMBER - PARK NICOLLET CLINIC - GOLDEN VALLEY

Laboratory Demographics

CLIA Number: 24D0402648

Facility Name: PARK NICOLLET CLINIC - GOLDEN VALLEY

Facility Address:
8401 GOLDEN VALLEY RD, SUITE 100
MINNEAPOLIS, MN
ZIP 55427
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Facility Phone Number: 952 993-8328

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1235695594

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	24D0402648
LAB Type	Physician Office
Facility Name	PARK NICOLLET CLINIC - GOLDEN VALLEY
Street	8401 GOLDEN VALLEY RD, SUITE 100
City	MINNEAPOLIS
State	MN
ZIP	55427
Phone	952 993-8328
CertificateType	1
CertificateEffectiveDate	4/18/2024
CertificateExpirationDate	4/17/2026
FacilityType	Accreditation

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This page was last updated on: 4/23/2024