24D2043139 CLIA NUMBER - M HEALTH FAIRVIEW RECOVERY SERVICES

Laboratory Demographics

  • CLIA Code: 24D2043139
  • Facility Name: M HEALTH FAIRVIEW RECOVERY SERVICES
  • Facility Address: 2312 6TH ST, SUITE F105
    MINNEAPOLIS, MN
    ZIP 55454
  • Facility Phone: 612 273-3565
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: PEDRO E. CASTANEDA
  • NPI Number: 1053952606
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2043139
LAB Type Community Clinic
Facility Name M HEALTH FAIRVIEW RECOVERY SERVICES
Street 2312 6TH ST, SUITE F105
City MINNEAPOLIS
State MN
ZIP 55454
Phone 612 273-3565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Community Clinic
Lab Director PEDRO E. CASTANEDA

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