24D1046860 CLIA NUMBER - CHILDREN'S MN MINNETONKA AMBULATORY SURGERY

Laboratory Demographics

CLIA Number: 24D1046860

Facility Name: CHILDREN'S MN MINNETONKA AMBULATORY SURGERY

Facility Address:
6050 CLEARWATER DRIVE, SUITE 300
MINNETONKA, MN
ZIP 55343
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Facility Phone Number: 612 813-6072

Facility Type: Ambulatory Surgery Center

Certificate Type: Accreditation

NPI Number: 1528167491

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D1046860
LAB Type	Ambulatory Surgery Center
Facility Name	CHILDREN'S MN MINNETONKA AMBULATORY SURGERY
Street	6050 CLEARWATER DRIVE, SUITE 300
City	MINNETONKA
State	MN
ZIP	55343
Phone	612 813-6072
CertificateType	1
CertificateEffectiveDate	11/15/2022
CertificateExpirationDate	11/14/2024
FacilityType	Accreditation

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