24D2082638 CLIA NUMBER - BLUESTONE PHYSICIAN SERVICES, PA

Laboratory Demographics

  • CLIA Code: 24D2082638
  • Facility Name: BLUESTONE PHYSICIAN SERVICES, PA
  • Facility Address: 270 NORTH MAIN ST, STE 300
    STILLWATER, MN
    ZIP 55082
  • Facility Phone: 651 342-1039
  • Facility Type: Other - MOBILE PRIMARY CARE PRACT
  • Facility Type: Waiver
  • Lab Director: RAJIV PATEL
  • NPI Number: 1578595971
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 24D2082638
LAB Type Other - MOBILE PRIMARY CARE PRACT
Facility Name BLUESTONE PHYSICIAN SERVICES, PA
Street 270 NORTH MAIN ST, STE 300
City STILLWATER
State MN
ZIP 55082
Phone 651 342-1039
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Other - MOBILE PRIMARY CARE PRACT
Lab Director RAJIV PATEL

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