24D0941889 CLIA NUMBER - RIVERWAY CLINIC - ANDOVER

Laboratory Demographics

CLIA Number: 24D0941889

Facility Name: RIVERWAY CLINIC - ANDOVER

Facility Address:
15245 BLUEBIRD STREET NW
ANDOVER, MN
ZIP 55304
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Facility Phone Number: 763 587-4616

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1730240649

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	24D0941889
LAB Type	Physician Office
Facility Name	RIVERWAY CLINIC - ANDOVER
Street	15245 BLUEBIRD STREET NW
City	ANDOVER
State	MN
ZIP	55304
Phone	763 587-4616
CertificateType	1
CertificateEffectiveDate	5/12/2024
CertificateExpirationDate	5/11/2026
FacilityType	Accreditation

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This page was last updated on: 4/23/2024