24D2052647 CLIA NUMBER - MINNESOTA EYE INSTITUTE INC

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Laboratory Demographics

CLIA Number: 24D2052647

Facility Name: MINNESOTA EYE INSTITUTE INC

Facility Address:
3401 SOUTH BROADWAY
ALEXANDRIA, MN
ZIP 56308
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Facility Phone Number: 320 759-2020

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003802950

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D2052647
LAB Type	Physician Office
Facility Name	MINNESOTA EYE INSTITUTE INC
Street	3401 SOUTH BROADWAY
City	ALEXANDRIA
State	MN
ZIP	56308
Phone	320 759-2020
CertificateType	4
CertificateEffectiveDate	1/15/2023
CertificateExpirationDate	1/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024