24D1050288 CLIA NUMBER - ST CLOUD MN OPHTHALMOLOGY ASC LLC,THE ST CLOUD CENTER FOR OPHTHALMIC SURGERY

Laboratory Demographics

  • CLIA Code: 24D1050288
  • Facility Name: ST CLOUD MN OPHTHALMOLOGY ASC LLC,THE ST CLOUD CENTER FOR OPHTHALMIC SURGERY
  • Facility Address: 2055 NORTH 15TH STREET, STE B
    SAINT CLOUD, MN
    ZIP 56303
  • Facility Phone: 320 258-6620
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RICHARD LUCIUS
  • NPI Number: 1467499293
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D1050288
LAB Type Ambulatory Surgery Center
Facility Name ST CLOUD MN OPHTHALMOLOGY ASC LLC,THE ST CLOUD CENTER FOR OPHTHALMIC SURGERY
Street 2055 NORTH 15TH STREET, STE B
City SAINT CLOUD
State MN
ZIP 56303
Phone 320 258-6620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Ambulatory Surgery Center
Lab Director RICHARD LUCIUS

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