24D1032355 CLIA NUMBER - CLINIC SOFIA OB/GYN PA

Laboratory Demographics

  • CLIA Code: 24D1032355
  • Facility Name: CLINIC SOFIA OB/GYN PA
  • Facility Address: 6545 FRANCE AVE S #490
    EDINA, MN
    ZIP 55435
  • Facility Phone: 952 922-7600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEWELIA WAGNER
  • NPI Number: 1245218825
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 24D1032355
LAB Type Physician Office
Facility Name CLINIC SOFIA OB/GYN PA
Street 6545 FRANCE AVE S #490
City EDINA
State MN
ZIP 55435
Phone 952 922-7600
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/13/2024
Certificate Expiration Date 10/12/2026
Facility Type Physician Office
Lab Director JEWELIA WAGNER

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