24D2008534 CLIA NUMBER - NINE MILE CREEK SENIOR LIVING

Laboratory Demographics

  • CLIA Code: 24D2008534
  • Facility Name: NINE MILE CREEK SENIOR LIVING
  • Facility Address: 2301 VILLAGE LANE
    BLOOMINGTON, MN
    ZIP 55431
  • Facility Phone: 952 888-0731
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LEANNE OBERNOLTE
  • NPI Number: 1295008787
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2008534
LAB Type Assisted Living Facility
Facility Name NINE MILE CREEK SENIOR LIVING
Street 2301 VILLAGE LANE
City BLOOMINGTON
State MN
ZIP 55431
Phone 952 888-0731
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Assisted Living Facility
Lab Director LEANNE OBERNOLTE

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