24D0651360 CLIA NUMBER - CREST VIEW LUTHERAN HOME

Laboratory Demographics

  • CLIA Code: 24D0651360
  • Facility Name: CREST VIEW LUTHERAN HOME
  • Facility Address: 4444 RESERVOIR BLVD NE
    COLUMBIA HEIGHTS, MN
    ZIP 55421
  • Facility Phone: 763 782-1611
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SIMON MITTAL
  • NPI Number: 1497316129
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 24D0651360
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CREST VIEW LUTHERAN HOME
Street 4444 RESERVOIR BLVD NE
City COLUMBIA HEIGHTS
State MN
ZIP 55421
Phone 763 782-1611
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

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