24D0879933 CLIA NUMBER - MINNESOTA CORRECTIONAL FACILITY LINO LAKES

Laboratory Demographics

  • CLIA Code: 24D0879933
  • Facility Name: MINNESOTA CORRECTIONAL FACILITY LINO LAKES
  • Facility Address: 7525 FOURTH AVE
    LINO LAKES, MN
    ZIP 55014
  • Facility Phone: 651 717-6550
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: DAVID PAULSON
  • NPI Number: 1114781739
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 24D0879933
LAB Type Prison
Facility Name MINNESOTA CORRECTIONAL FACILITY LINO LAKES
Street 7525 FOURTH AVE
City LINO LAKES
State MN
ZIP 55014
Phone 651 717-6550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2024
Certificate Expiration Date 7/2/2026
Facility Type Prison
Lab Director DAVID PAULSON

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