24D2015463 CLIA NUMBER - CROSSTOWN SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 24D2015463
  • Facility Name: CROSSTOWN SURGERY CENTER LLC
  • Facility Address: 4010 WEST 65TH STREET
    EDINA, MN
    ZIP 55435
  • Facility Phone: (952) 456-7300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: EDWARD KELLY
  • NPI Number: 1720398167
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2015463
LAB Type Ambulatory Surgery Center
Facility Name CROSSTOWN SURGERY CENTER LLC
Street 4010 WEST 65TH STREET
City EDINA
State MN
ZIP 55435
Phone 9524567300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Ambulatory Surgery Center
Lab Director EDWARD KELLY

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This page was last updated on: 5/18/2026