24D2099842 CLIA NUMBER - KOREAN SERIVCE CENTER

Laboratory Demographics

  • CLIA Code: 24D2099842
  • Facility Name: KOREAN SERIVCE CENTER
  • Facility Address: 630 CEDAR AVE SOUTH SUITE 81
    MINNEAPOLIS, MN
    ZIP 55454
  • Facility Phone: 612 342-1345
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: KWANGJA KWON
  • NPI Number: 1669601423
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2099842
LAB Type Assisted Living Facility
Facility Name KOREAN SERIVCE CENTER
Street 630 CEDAR AVE SOUTH SUITE 81
City MINNEAPOLIS
State MN
ZIP 55454
Phone 612 342-1345
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Assisted Living Facility
Lab Director KWANGJA KWON

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