24D2074490 CLIA NUMBER - BEACON HOME OF EAGAN

Laboratory Demographics

  • CLIA Code: 24D2074490
  • Facility Name: BEACON HOME OF EAGAN
  • Facility Address: 3808 BLACKHAWK RIDGE PLACE
    EAGAN, MN
    ZIP 55122
  • Facility Phone: 651 330-2108
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: AUTUMN OSTERFAARD
  • NPI Number: 1700205556
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2074490
LAB Type Assisted Living Facility
Facility Name BEACON HOME OF EAGAN
Street 3808 BLACKHAWK RIDGE PLACE
City EAGAN
State MN
ZIP 55122
Phone 651 330-2108
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Assisted Living Facility
Lab Director AUTUMN OSTERFAARD

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