24D2006406 CLIA NUMBER - PIIC CLINICAL SERVICES, PC IN BROOKLYN CENTER

Laboratory Demographics

  • CLIA Code: 24D2006406
  • Facility Name: PIIC CLINICAL SERVICES, PC IN BROOKLYN CENTER
  • Facility Address: 6500 HUMBOLT AVENUE NORTH
    BROOKLYN CENTER, MN
    ZIP 55430
  • Facility Phone: 952 698-9860
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELISE LARSON
  • NPI Number: 1376041822
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2006406
LAB Type Physician Office
Facility Name PIIC CLINICAL SERVICES, PC IN BROOKLYN CENTER
Street 6500 HUMBOLT AVENUE NORTH
City BROOKLYN CENTER
State MN
ZIP 55430
Phone 952 698-9860
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2024
Certificate Expiration Date 4/20/2026
Facility Type Physician Office
Lab Director ELISE LARSON

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