24D2071978 CLIA NUMBER - PLYMOUTH SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 24D2071978
  • Facility Name: PLYMOUTH SURGERY CENTER
  • Facility Address: 6050 SYCAMORE LANE N STE 200
    PLYMOUTH, MN
    ZIP 55446
  • Facility Phone: 952 814-6644
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BECKIE HINES
  • NPI Number: 1497120588
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2071978
LAB Type Ambulatory Surgery Center
Facility Name PLYMOUTH SURGERY CENTER
Street 6050 SYCAMORE LANE N STE 200
City PLYMOUTH
State MN
ZIP 55446
Phone 952 814-6644
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2024
Certificate Expiration Date 1/21/2026
Facility Type Ambulatory Surgery Center
Lab Director BECKIE HINES

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