24D0926450 CLIA NUMBER - UNIVERSITY DIALYSIS UNIT RIVERSIDE

Laboratory Demographics

  • CLIA Code: 24D0926450
  • Facility Name: UNIVERSITY DIALYSIS UNIT RIVERSIDE
  • Facility Address: 1045 WESTGATE DRIVE SUITE 90
    SAINT PAUL, MN
    ZIP 55114
  • Facility Phone: 651 645-1847
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CONNIE MANSKE
  • NPI Number: 1083678379
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0926450
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name UNIVERSITY DIALYSIS UNIT RIVERSIDE
Street 1045 WESTGATE DRIVE SUITE 90
City SAINT PAUL
State MN
ZIP 55114
Phone 651 645-1847
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CONNIE MANSKE

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