24D2106602 CLIA NUMBER - VALHALLA PLACE CLINIC, PA

Laboratory Demographics

  • CLIA Code: 24D2106602
  • Facility Name: VALHALLA PLACE CLINIC, PA
  • Facility Address: 6043 HUDSON ROAD SUITE 220
    WOODBURY, MN
    ZIP 55125
  • Facility Phone: 651 724-0154
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LYNN D. SOLEM
  • NPI Number: 1881856664
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2106602
LAB Type Physician Office
Facility Name VALHALLA PLACE CLINIC, PA
Street 6043 HUDSON ROAD SUITE 220
City WOODBURY
State MN
ZIP 55125
Phone 651 724-0154
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type Physician Office
Lab Director LYNN D. SOLEM

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