24D1044701 CLIA NUMBER - ST PAUL RHEUMATOLOGY

Laboratory Demographics

CLIA Number: 24D1044701

Facility Name: ST PAUL RHEUMATOLOGY

Facility Address:
2854 HIGHWAY 55 SUITE 190
EAGAN, MN
ZIP 55121
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Facility Phone Number: 651 644-4277

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053344788

Taxonomy: 207RR0500X - Internal Medicine
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

CLIA Record

Field Name	Field Value
CLIA Number	24D1044701
LAB Type	Physician Office
Facility Name	ST PAUL RHEUMATOLOGY
Street	2854 HIGHWAY 55 SUITE 190
City	EAGAN
State	MN
ZIP	55121
Phone	651 644-4277
CertificateType	4
CertificateEffectiveDate	8/25/2023
CertificateExpirationDate	8/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024