24D1055175 CLIA NUMBER - EPIPHANY DERMATOLOGY OF MINNESOTA, LLC

Laboratory Demographics

  • CLIA Code: 24D1055175
  • Facility Name: EPIPHANY DERMATOLOGY OF MINNESOTA, LLC
  • Facility Address: 20520 KEOKUK AVE SUITE 104
    LAKEVILLE, MN
    ZIP 55044
  • Facility Phone: 952 469-5033
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ROBERT J. ZABEL
  • NPI Number: 1467649939
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 24D1055175
LAB Type Physician Office
Facility Name EPIPHANY DERMATOLOGY OF MINNESOTA, LLC
Street 20520 KEOKUK AVE SUITE 104
City LAKEVILLE
State MN
ZIP 55044
Phone 952 469-5033
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Physician Office
Lab Director ROBERT J. ZABEL

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