24D0718074 CLIA NUMBER - NORTHWESTERN HEALTH SCIENCES UNIVERSITY - CLINICAL LABORATORY

Laboratory Demographics

CLIA Number: 24D0718074

Facility Name: NORTHWESTERN HEALTH SCIENCES UNIVERSITY - CLINICAL LABORATORY

Facility Address:
2501 W 84TH STREET
BLOOMINGTON, MN
ZIP 55431
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Facility Phone Number: 952 885-5434

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1124103544

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D0718074
LAB Type	Other
Facility Name	NORTHWESTERN HEALTH SCIENCES UNIVERSITY - CLINICAL LABORATORY
Street	2501 W 84TH STREET
City	BLOOMINGTON
State	MN
ZIP	55431
Phone	952 885-5434
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024