24D1105289 CLIA NUMBER - NORTH METRO SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 24D1105289
  • Facility Name: NORTH METRO SURGERY CENTER
  • Facility Address: 11855 ULYSSES STREET SUITE 270
    BLAINE, MN
    ZIP 55434
  • Facility Phone: 763 755-6540
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GEORGE WANDLING
  • NPI Number: 1760616031
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D1105289
LAB Type Ambulatory Surgery Center
Facility Name NORTH METRO SURGERY CENTER
Street 11855 ULYSSES STREET SUITE 270
City BLAINE
State MN
ZIP 55434
Phone 763 755-6540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2025
Certificate Expiration Date 9/20/2027
Facility Type Ambulatory Surgery Center
Lab Director GEORGE WANDLING

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