24D0996196 CLIA NUMBER - ECUMEN LAKEVIEW COMMONS

Laboratory Demographics

  • CLIA Code: 24D0996196
  • Facility Name: ECUMEN LAKEVIEW COMMONS
  • Facility Address: 1200 NORTH LAKEWOOD DRIVE
    MAPLEWOOD, MN
    ZIP 55119
  • Facility Phone: 651 770-1111
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TAMI HALEY
  • NPI Number: 1649484601
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0996196
LAB Type Assisted Living Facility
Facility Name ECUMEN LAKEVIEW COMMONS
Street 1200 NORTH LAKEWOOD DRIVE
City MAPLEWOOD
State MN
ZIP 55119
Phone 651 770-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2024
Certificate Expiration Date 2/11/2026
Facility Type Assisted Living Facility
Lab Director TAMI HALEY

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