24D0691425 CLIA NUMBER - WEST ST PAUL DIALYSIS UNIT

Laboratory Demographics

  • CLIA Code: 24D0691425
  • Facility Name: WEST ST PAUL DIALYSIS UNIT
  • Facility Address: 1555 LIVINGSTON AVENUE
    WEST SAINT PAUL, MN
    ZIP 55118
  • Facility Phone: 651 455-2995
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SHANNON DOYLE
  • NPI Number: 1093779399
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0691425
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WEST ST PAUL DIALYSIS UNIT
Street 1555 LIVINGSTON AVENUE
City WEST SAINT PAUL
State MN
ZIP 55118
Phone 651 455-2995
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SHANNON DOYLE

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