24D2032762 CLIA NUMBER - PHS WOODBURY INC DBA STONECREST

Laboratory Demographics

  • CLIA Code: 24D2032762
  • Facility Name: PHS WOODBURY INC DBA STONECREST
  • Facility Address: 8725 PROMENADE LANE
    WOODBURY, MN
    ZIP 55125
  • Facility Phone: 651 264-3330
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MARY WIENS
  • NPI Number: 1588088322
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2032762
LAB Type Assisted Living Facility
Facility Name PHS WOODBURY INC DBA STONECREST
Street 8725 PROMENADE LANE
City WOODBURY
State MN
ZIP 55125
Phone 651 264-3330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Assisted Living Facility
Lab Director MARY WIENS

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