24D1028387 CLIA NUMBER - AMIRA CHOICE CHAMPLIN LLC

Laboratory Demographics

  • CLIA Code: 24D1028387
  • Facility Name: AMIRA CHOICE CHAMPLIN LLC
  • Facility Address: 119 E HAYDEN LAKE RD
    CHAMPLIN, MN
    ZIP 55316
  • Facility Phone: 763 712-0118
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: EDNA NYARIBO
  • NPI Number: 1194845107
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1028387
LAB Type Assisted Living Facility
Facility Name AMIRA CHOICE CHAMPLIN LLC
Street 119 E HAYDEN LAKE RD
City CHAMPLIN
State MN
ZIP 55316
Phone 763 712-0118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Assisted Living Facility
Lab Director EDNA NYARIBO

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