24D1034582 CLIA NUMBER - M HEALTH FAIRVIEW IMAGING MAPLEWOOD

Laboratory Demographics

  • CLIA Code: 24D1034582
  • Facility Name: M HEALTH FAIRVIEW IMAGING MAPLEWOOD
  • Facility Address: 2945 HAZELWOOD ST N SUITE 110
    MAPLEWOOD, MN
    ZIP 55109
  • Facility Phone: 651 747-4500
  • Facility Type: Other - OP IMAGING CENTER
  • Facility Type: Waiver
  • Lab Director: SUSAN M. STOLTZ
  • NPI Number: 1083679484
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D1034582
LAB Type Other - OP IMAGING CENTER
Facility Name M HEALTH FAIRVIEW IMAGING MAPLEWOOD
Street 2945 HAZELWOOD ST N SUITE 110
City MAPLEWOOD
State MN
ZIP 55109
Phone 651 747-4500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Other - OP IMAGING CENTER
Lab Director SUSAN M. STOLTZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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