24D0861875 CLIA NUMBER - EBENEZER INTEGRATED CARE & REHAB

Laboratory Demographics

  • CLIA Code: 24D0861875
  • Facility Name: EBENEZER INTEGRATED CARE & REHAB
  • Facility Address: 45 W 10TH ST
    SAINT PAUL, MN
    ZIP 55102
  • Facility Phone: 612 879-2262
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: THOMAS VONSTERNBERG
  • NPI Number: 1174508873
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0861875
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EBENEZER INTEGRATED CARE & REHAB
Street 45 W 10TH ST
City SAINT PAUL
State MN
ZIP 55102
Phone 612 879-2262
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 THOMAS VONSTERNBERG

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