24D0693904 CLIA NUMBER - COTTAGE GROVE EMS

Laboratory Demographics

  • CLIA Code: 24D0693904
  • Facility Name: COTTAGE GROVE EMS
  • Facility Address: 12800 RAVINE PARKWAY SOUTH
    COTTAGE GROVE, MN
    ZIP 55016
  • Facility Phone: 651 458-2850
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: PETE KOERNER
  • NPI Number: 1851547970
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0693904
LAB Type Ambulance
Facility Name COTTAGE GROVE EMS
Street 12800 RAVINE PARKWAY SOUTH
City COTTAGE GROVE
State MN
ZIP 55016
Phone 651 458-2850
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 Ambulance
Lab Director PETE KOERNER

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