24D0868744 CLIA NUMBER - ALLINA HEALTH ISLES CLINIC

Laboratory Demographics

  • CLIA Code: 24D0868744
  • Facility Name: ALLINA HEALTH ISLES CLINIC
  • Facility Address: 2800 HENNEPIN AVENUE
    MINNEAPOLIS, MN
    ZIP 55408
  • Facility Phone: 612 863-0408
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. MILTON W. DATTA
  • NPI Number: 1508162249
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 24D0868744
LAB Type Community Clinic
Facility Name ALLINA HEALTH ISLES CLINIC
Street 2800 HENNEPIN AVENUE
City MINNEAPOLIS
State MN
ZIP 55408
Phone 612 863-0408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Community Clinic
Lab Director DR. MILTON W. DATTA

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