24D0873142 CLIA NUMBER - OCCUPATIONAL MEDICINE CONSULTANTS

Laboratory Demographics

  • CLIA Code: 24D0873142
  • Facility Name: OCCUPATIONAL MEDICINE CONSULTANTS
  • Facility Address: 6515 BARRIE RD SUITE #150
    EDINA, MN
    ZIP 55435
  • Facility Phone: 952 920-5663
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: THOMAS C. JETZER
  • NPI Number: 1962624437
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0873142
LAB Type Other
Facility Name OCCUPATIONAL MEDICINE CONSULTANTS
Street 6515 BARRIE RD SUITE #150
City EDINA
State MN
ZIP 55435
Phone 952 920-5663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2025
Certificate Expiration Date 7/7/2027
Facility Type Other
Lab Director THOMAS C. JETZER

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