24D2128716 CLIA NUMBER - AVALON HOSPICE MINNESOTA, LLC DBA GENTIVA

Laboratory Demographics

  • CLIA Code: 24D2128716
  • Facility Name: AVALON HOSPICE MINNESOTA, LLC DBA GENTIVA
  • Facility Address: 1821 UNIVERSITY AVENUE, SUITE 252
    SAINT PAUL, MN
    ZIP 55104
  • Facility Phone: 704 664-2876
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE Y. BEASLEY
  • NPI Number: 1902343353
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 24D2128716
LAB Type Hospice
Facility Name AVALON HOSPICE MINNESOTA, LLC DBA GENTIVA
Street 1821 UNIVERSITY AVENUE, SUITE 252
City SAINT PAUL
State MN
ZIP 55104
Phone 704 664-2876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Hospice
Lab Director SELECE Y. BEASLEY

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