24D1027732 CLIA NUMBER - BRASK HAVEN INC

Laboratory Demographics

  • CLIA Code: 24D1027732
  • Facility Name: BRASK HAVEN INC
  • Facility Address: 31274 JULLIARD ST NE
    NORTH BRANCH, MN
    ZIP 55056
  • Facility Phone: 651 674-7433
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: ETTAFA L. BOKA
  • NPI Number: 1780765487
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1027732
LAB Type Other
Facility Name BRASK HAVEN INC
Street 31274 JULLIARD ST NE
City NORTH BRANCH
State MN
ZIP 55056
Phone 651 674-7433
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2024
Certificate Expiration Date 7/7/2026
Facility Type Other
Lab Director ETTAFA L. BOKA

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