24D1087387 CLIA NUMBER - REM HENNEPIN INC - CRYSTAL

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Field Name	Field Value
CLIA Number	24D1087387
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	REM HENNEPIN INC - CRYSTAL
Street	3400 QUAIL AVE N
City	CRYSTAL
State	MN
ZIP	55422
Phone	952 591-0797
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/1/2024
Certificate Expiration Date	7/31/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	MAMIE L. FOLERTS

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