24D0861584 CLIA NUMBER - HEALTHSOURCE SOLUTIONS, LLC

Laboratory Demographics

  • CLIA Code: 24D0861584
  • Facility Name: HEALTHSOURCE SOLUTIONS, LLC
  • Facility Address: 3149 FERNBROOK LANE NORTH
    PLYMOUTH, MN
    ZIP 55447
  • Facility Phone: 763 287-0740
  • Facility Type: Health Fair
  • Facility Type: Waiver
  • Lab Director: AMY BURT
  • NPI Number: 1942501689
  • Taxonomy: 174H00000X - Health Educator

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CLIA Record

Field Name Field Value
CLIA Number 24D0861584
LAB Type Health Fair
Facility Name HEALTHSOURCE SOLUTIONS, LLC
Street 3149 FERNBROOK LANE NORTH
City PLYMOUTH
State MN
ZIP 55447
Phone 763 287-0740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2024
Certificate Expiration Date 3/8/2026
Facility Type Health Fair
Lab Director AMY BURT

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