24D2056596 CLIA NUMBER - MEADOW CREEK DBA EOSIS MEADOW CREEK

Laboratory Demographics

  • CLIA Code: 24D2056596
  • Facility Name: MEADOW CREEK DBA EOSIS MEADOW CREEK
  • Facility Address: 17305 MEADOW CREEK LANE
    PINE CITY, MN
    ZIP 55063
  • Facility Phone: 612 454-5000
  • Facility Type: Other - SUB TREATMENT FACILITY
  • Facility Type: Waiver
  • Lab Director: ERNEST LAMPE
  • NPI Number: 1942413687
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2056596
LAB Type Other - SUB TREATMENT FACILITY
Facility Name MEADOW CREEK DBA EOSIS MEADOW CREEK
Street 17305 MEADOW CREEK LANE
City PINE CITY
State MN
ZIP 55063
Phone 612 454-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Other - SUB TREATMENT FACILITY
Lab Director ERNEST LAMPE

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