24D0669718 CLIA NUMBER - NEW BRIGHTON A VILLA CENTER

Laboratory Demographics

  • CLIA Code: 24D0669718
  • Facility Name: NEW BRIGHTON A VILLA CENTER
  • Facility Address: 825 1ST AVENUE NW
    NEW BRIGHTON, MN
    ZIP 55112
  • Facility Phone: 651 633-7875
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: PAXTON WIFFLER
  • NPI Number: 1568541514
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0669718
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name NEW BRIGHTON A VILLA CENTER
Street 825 1ST AVENUE NW
City NEW BRIGHTON
State MN
ZIP 55112
Phone 651 633-7875
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 PAXTON WIFFLER

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