24D2076075 CLIA NUMBER - DEEPHAVEN WOODS ST THERESE SENIOR LIVING, LLC

Laboratory Demographics

  • CLIA Code: 24D2076075
  • Facility Name: DEEPHAVEN WOODS ST THERESE SENIOR LIVING, LLC
  • Facility Address: 18025 MINNETONKA BLVD
    DEEPHAVEN, MN
    ZIP 55391
  • Facility Phone: 952 288-2187
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: KERRY COLLINS
  • NPI Number: 1790882785
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 24D2076075
LAB Type Assisted Living Facility
Facility Name DEEPHAVEN WOODS ST THERESE SENIOR LIVING, LLC
Street 18025 MINNETONKA BLVD
City DEEPHAVEN
State MN
ZIP 55391
Phone 952 288-2187
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Assisted Living Facility
Lab Director KERRY COLLINS

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