24D2032761 CLIA NUMBER - EAGLE CREST LLC

Laboratory Demographics

  • CLIA Code: 24D2032761
  • Facility Name: EAGLE CREST LLC
  • Facility Address: 2945 LINCOLN DRIVE
    ROSEVILLE, MN
    ZIP 55113
  • Facility Phone: (651) 628-3011
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: RICHARD GORA

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CLIA Record

Field Name Field Value
CLIA Number 24D2032761
LAB Type Assisted Living Facility
Facility Name EAGLE CREST LLC
Street 2945 LINCOLN DRIVE
City ROSEVILLE
State MN
ZIP 55113
Phone 6516283011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2025
Certificate Expiration Date 11/14/2027
Facility Type Assisted Living Facility
Lab Director RICHARD GORA

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