24D1026543 CLIA NUMBER - NORTHERN OAKS PLACE

Laboratory Demographics

  • CLIA Code: 24D1026543
  • Facility Name: NORTHERN OAKS PLACE
  • Facility Address: 1005 PAUL PARKWAY NE
    BLAINE, MN
    ZIP 55434
  • Facility Phone: 763 219-1733
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MOLLY FROVIK
  • NPI Number: 1932832854
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 24D1026543
LAB Type Assisted Living Facility
Facility Name NORTHERN OAKS PLACE
Street 1005 PAUL PARKWAY NE
City BLAINE
State MN
ZIP 55434
Phone 763 219-1733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2024
Certificate Expiration Date 6/7/2026
Facility Type Assisted Living Facility
Lab Director MOLLY FROVIK

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