24D0858026 CLIA NUMBER - M HEALTH FAIRVIEW CLINIC - EAGAN

Laboratory Demographics

CLIA Number: 24D0858026

Facility Name: M HEALTH FAIRVIEW CLINIC - EAGAN

Facility Address:
3305 CENTRAL PARK VILLAGE DRIVE SUITE 200
EAGAN, MN
ZIP 55121
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Facility Phone Number: 651 688-7860

Facility Type: Community Clinic

Certificate Type: Accreditation

NPI Number: 1043402688

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D0858026
LAB Type	Community Clinic
Facility Name	M HEALTH FAIRVIEW CLINIC - EAGAN
Street	3305 CENTRAL PARK VILLAGE DRIVE SUITE 200
City	EAGAN
State	MN
ZIP	55121
Phone	651 688-7860
CertificateType	1
CertificateEffectiveDate	4/22/2024
CertificateExpirationDate	4/21/2026
FacilityType	Accreditation

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