24D2060074 CLIA NUMBER - GREENWAY VISION

Laboratory Demographics

  • CLIA Code: 24D2060074
  • Facility Name: GREENWAY VISION
  • Facility Address: 3252A WEST LAKE ST
    MINNEAPOLIS, MN
    ZIP 55416
  • Facility Phone: 612 926-2878
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GRANVILLE P. LAWRENCE
  • NPI Number: 1114015732
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 24D2060074
LAB Type Physician Office
Facility Name GREENWAY VISION
Street 3252A WEST LAKE ST
City MINNEAPOLIS
State MN
ZIP 55416
Phone 612 926-2878
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Physician Office
Lab Director GRANVILLE P. LAWRENCE

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