24D2096335 CLIA NUMBER - ST PAUL CLINIC

Laboratory Demographics

  • CLIA Code: 24D2096335
  • Facility Name: ST PAUL CLINIC
  • Facility Address: 301 UNIVERSITY AVENUE WEST
    SAINT PAUL, MN
    ZIP 55103
  • Facility Phone: 651 447-7113
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: PA FOUA J. YANG
  • NPI Number: 1861901324
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2096335
LAB Type Community Clinic
Facility Name ST PAUL CLINIC
Street 301 UNIVERSITY AVENUE WEST
City SAINT PAUL
State MN
ZIP 55103
Phone 651 447-7113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Community Clinic
Lab Director PA FOUA J. YANG

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This page was last updated on: 6/4/2025