24D0969615 CLIA NUMBER - METROPOLITAN HEART AND VASCULAR INSTITUTE

Laboratory Demographics

CLIA Number: 24D0969615

Facility Name: METROPOLITAN HEART AND VASCULAR INSTITUTE

Facility Address:
4040 COON RAPIDS BLVD STE 120
COON RAPIDS, MN
ZIP 55433
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Facility Phone Number: 763 236-9196

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1225076136

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	24D0969615
LAB Type	Physician Office
Facility Name	METROPOLITAN HEART AND VASCULAR INSTITUTE
Street	4040 COON RAPIDS BLVD STE 120
City	COON RAPIDS
State	MN
ZIP	55433
Phone	763 236-9196
CertificateType	4
CertificateEffectiveDate	1/21/2024
CertificateExpirationDate	1/20/2026
FacilityType	Waiver

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