24D1019602 CLIA NUMBER - KENT J ERICKSON DC CHTD BROOKDALE INTEGRATIVE HEALTH

Laboratory Demographics

  • CLIA Code: 24D1019602
  • Facility Name: KENT J ERICKSON DC CHTD BROOKDALE INTEGRATIVE HEALTH
  • Facility Address: 5740 BROOKLYN BLVD STE 200
    BROOKLYN CENTER, MN
    ZIP 55429
  • Facility Phone: 763 561-4045
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KENT J. ERICKSON
  • NPI Number: 1740217694
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 24D1019602
LAB Type Practitioner Other
Facility Name KENT J ERICKSON DC CHTD BROOKDALE INTEGRATIVE HEALTH
Street 5740 BROOKLYN BLVD STE 200
City BROOKLYN CENTER
State MN
ZIP 55429
Phone 763 561-4045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Practitioner Other
Lab Director KENT J. ERICKSON

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