24D2019256 CLIA NUMBER - HENNEPIN COUNTY JUVENILE DETENTION CENTER

Laboratory Demographics

  • CLIA Code: 24D2019256
  • Facility Name: HENNEPIN COUNTY JUVENILE DETENTION CENTER
  • Facility Address: 510 PARK AVENUE
    MINNEAPOLIS, MN
    ZIP 55407
  • Facility Phone: 612 255-0628
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: HEIDI EWING
  • NPI Number: 1780790345
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 24D2019256
LAB Type Prison
Facility Name HENNEPIN COUNTY JUVENILE DETENTION CENTER
Street 510 PARK AVENUE
City MINNEAPOLIS
State MN
ZIP 55407
Phone 612 255-0628
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Prison
Lab Director HEIDI EWING

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