24D2072478 CLIA NUMBER - THE WELL-EDEN PRAIRIE, OPTUM CIRCLE

Laboratory Demographics

  • CLIA Code: 24D2072478
  • Facility Name: THE WELL-EDEN PRAIRIE, OPTUM CIRCLE
  • Facility Address: 2 OPTUM CIRCLE
    EDEN PRAIRIE, MN
    ZIP 55344
  • Facility Phone: 952 205-2170
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILLIP CARRON
  • NPI Number: 1841716883
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 24D2072478
LAB Type Physician Office
Facility Name THE WELL-EDEN PRAIRIE, OPTUM CIRCLE
Street 2 OPTUM CIRCLE
City EDEN PRAIRIE
State MN
ZIP 55344
Phone 952 205-2170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Physician Office
Lab Director PHILLIP CARRON

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