24D0695665 CLIA NUMBER - MAPLEWOOD GOOD SAMARITAN

Laboratory Demographics

  • CLIA Code: 24D0695665
  • Facility Name: MAPLEWOOD GOOD SAMARITAN
  • Facility Address: 550 ROSELAWN AVE EAST
    MAPLEWOOD, MN
    ZIP 55117
  • Facility Phone: 651 774-9765
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SUSAN B. JENSEN
  • NPI Number: 1811631807
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0695665
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MAPLEWOOD GOOD SAMARITAN
Street 550 ROSELAWN AVE EAST
City MAPLEWOOD
State MN
ZIP 55117
Phone 651 774-9765
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 SUSAN B. JENSEN

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