24D2097108 CLIA NUMBER - BLAINE WP II, LLC

Laboratory Demographics

  • CLIA Code: 24D2097108
  • Facility Name: BLAINE WP II, LLC
  • Facility Address: 12402 JAMESTOWN STREET NE
    BLAINE, MN
    ZIP 55449
  • Facility Phone: 763 205-4163
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: BRITTANY RANDS
  • NPI Number: 1871989806
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2097108
LAB Type Assisted Living Facility
Facility Name BLAINE WP II, LLC
Street 12402 JAMESTOWN STREET NE
City BLAINE
State MN
ZIP 55449
Phone 763 205-4163
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Assisted Living Facility
Lab Director BRITTANY RANDS

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