24D0886050 CLIA NUMBER - SOUTHSIDE CARE CENTER

Laboratory Demographics

  • CLIA Code: 24D0886050
  • Facility Name: SOUTHSIDE CARE CENTER
  • Facility Address: 2644 ALDRICH AVENUE SOUTH
    MINNEAPOLIS, MN
    ZIP 55408
  • Facility Phone: 612 872-4233
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: EMMANUEL TANDOH
  • NPI Number: 1063565398
  • Taxonomy: 310500000X - Intermediate Care Facility, Mental Illness

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CLIA Record

Field Name Field Value
CLIA Number 24D0886050
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SOUTHSIDE CARE CENTER
Street 2644 ALDRICH AVENUE SOUTH
City MINNEAPOLIS
State MN
ZIP 55408
Phone 612 872-4233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2024
Certificate Expiration Date 5/11/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director EMMANUEL TANDOH

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