24D0978828 CLIA NUMBER - EAGAN VALLEY PEDIATRICS

Laboratory Demographics

  • CLIA Code: 24D0978828
  • Facility Name: EAGAN VALLEY PEDIATRICS
  • Facility Address: 14135 CEDAR AVE
    APPLE VALLEY, MN
    ZIP 55124
  • Facility Phone: 952 432-4373
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JAMES E. DUFORT
  • NPI Number: 1528050119
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0978828
LAB Type Physician Office
Facility Name EAGAN VALLEY PEDIATRICS
Street 14135 CEDAR AVE
City APPLE VALLEY
State MN
ZIP 55124
Phone 952 432-4373
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type Physician Office
Lab Director JAMES E. DUFORT

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