24D1055170 CLIA NUMBER - TWIN CITIES MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 24D1055170
  • Facility Name: TWIN CITIES MEDICAL CLINIC
  • Facility Address: 4601 EXCELSIOR BLVD, SUITE 407
    SAINT LOUIS PARK, MN
    ZIP 55416
  • Facility Phone: 952 922-0169
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CLAES ERIK M. OLDENBURG
  • NPI Number: 1780625491
  • Taxonomy: 207T00000X - Neurological Surgery

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CLIA Record

Field Name Field Value
CLIA Number 24D1055170
LAB Type Physician Office
Facility Name TWIN CITIES MEDICAL CLINIC
Street 4601 EXCELSIOR BLVD, SUITE 407
City SAINT LOUIS PARK
State MN
ZIP 55416
Phone 952 922-0169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2024
Certificate Expiration Date 6/11/2026
Facility Type Physician Office
Lab Director CLAES ERIK M. OLDENBURG

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