24D2005019 CLIA NUMBER - ANNA WESTIN HOUSE FIRST FLOOR

Laboratory Demographics

CLIA Code: 24D2005019
Facility Name: ANNA WESTIN HOUSE FIRST FLOOR
Facility Address: 1449 CLEVELAND AVENUE N
SAINT PAUL, MN
ZIP 55108
Facility Phone: 651 645-5323
Facility Type: Other - RESIDENTAIL TREATMENT FAC
Facility Type: Waiver
Lab Director: DR. MARY BRETZMAN
NPI Number: 1649309246
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	24D2005019
LAB Type	Other - RESIDENTAIL TREATMENT FAC
Facility Name	ANNA WESTIN HOUSE FIRST FLOOR
Street	1449 CLEVELAND AVENUE N
City	SAINT PAUL
State	MN
ZIP	55108
Phone	651 645-5323
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	3/18/2024
Certificate Expiration Date	3/17/2026
Facility Type	Other - RESIDENTAIL TREATMENT FAC
Lab Director	DR. MARY BRETZMAN

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