24D0672607 CLIA NUMBER - VILLAS AT ROSEVILLE, THE

Laboratory Demographics

  • CLIA Code: 24D0672607
  • Facility Name: VILLAS AT ROSEVILLE, THE
  • Facility Address: 1000 LOVELL AVE W
    ROSEVILLE, MN
    ZIP 55113
  • Facility Phone: 651 484-3378
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: PAXTON WIFFLER
  • NPI Number: 1881768323
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0672607
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name VILLAS AT ROSEVILLE, THE
Street 1000 LOVELL AVE W
City ROSEVILLE
State MN
ZIP 55113
Phone 651 484-3378
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